{ "in_network": [ { "billing_code": "10004", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration biopsy, without imaging guidance; each additional lesion (List separately in addition to code for primary procedure)", "name": "FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 34.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 36.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 36.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 38.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 39.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 40.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 40.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 2959, 2960, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 2975, 2978, 2980, 1958, 2984, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 41.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 43.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 3075, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 3038, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 3058, 2037, 2038, 3061, 3064, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 43.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 45.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 48.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2738, 2756, 2765, 2771, 2779, 2780, 2788, 1782, 1783, 2807, 1784, 1785, 1786, 1787, 1788, 1790, 1789, 1792, 2814, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 2828, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 2844, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 2857, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1791, 2872, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 2881, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 2894, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 2917, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 2927, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 50.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 50.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 51.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 53.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 54.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2738, 2756, 2765, 2771, 2779, 2780, 2788, 2807, 2814, 2828, 2844, 2857, 2872, 2881, 2894, 2917, 2927, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 54.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 55.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 57.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 59.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 63.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 65.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 68.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 71.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 86.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10005", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration biopsy, including ultrasound guidance; first lesion", "name": "FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 62.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 63.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 67.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 68.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 68.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 73.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 77.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 85.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 91.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 98.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.13, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 104.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 105.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 114.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 114.38, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 115.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 121.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 122.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 124.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 132.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 132.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 135.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 144.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 144.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 150.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 153.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "53", "54", "55", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 157.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 157.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 166.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 170.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 173.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 181.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 184.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 193.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 208.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 231.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 242.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10006", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration biopsy, including ultrasound guidance; each additional lesion (List separately in addition to code for primary procedure)", "name": "FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 39.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 42.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 43.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 2707, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 2959, 2960, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 2975, 2978, 2980, 1958, 2984, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 49.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 50.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 3075, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 3038, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 3058, 2037, 2038, 3061, 3064, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 51.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.7, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 53.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 53.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 55.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 2707, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2828, 2706, 2844, 2721, 2857, 2738, 2872, 2881, 2756, 2765, 2894, 2771, 2779, 2780, 2788, 2917, 2927, 2807, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 60.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 62.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 63.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2738, 2756, 2765, 2771, 2779, 2780, 2788, 2807, 2814, 2828, 2844, 2857, 2872, 2881, 2894, 2917, 2927, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 63.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 68.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2828, 2706, 2844, 2721, 2857, 2738, 2872, 2881, 2756, 2765, 2894, 2771, 2779, 2780, 2788, 2917, 2927, 2807, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 74.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 75.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 76.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 79.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 81.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 105.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10007", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion", "name": "FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 75.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 83.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.3, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 104.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 112.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.13, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 144.38, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 147.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 154.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 193.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 195.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 196.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 222.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 236.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 255.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 258.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 262.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 272.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 276.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 280.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 295.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 296.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 297.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 304.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 313.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 323.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 340.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 341.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 345.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 350.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 351.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 369.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 374.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 393.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 399.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 419.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 425.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 468.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 524.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 532.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10008", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration biopsy, including fluoroscopic guidance; each additional lesion (List separately in addition to code for primary procedure)", "name": "FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 48.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 49.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 53.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2707, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 57.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 60.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 61.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 65.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 65.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 71.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 77.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 79.63, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 82.55, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 91.88, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 98.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 122.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 123.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 124.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 140.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 149.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 151.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 167.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 168.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 183.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 188.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 198.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "53", "54", "55", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 202.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 208.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 211.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 217.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 222.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 232.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 264.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 278.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 290.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10009", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration biopsy, including CT guidance; first lesion", "name": "FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 91.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 97.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 106.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 115.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 122.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 122.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 144.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 153.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 177.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 188.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 188.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 235.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 236.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 240.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 363.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 384.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 388.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 410.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 416.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 423.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 429.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 444.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 458.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 471.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 485.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 487.05, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 497.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 513.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 520.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 522.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 529.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 555.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 573.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 573.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 600.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 603.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 612.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 640.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 643.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 765.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 800.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 804.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10010", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration biopsy, including CT guidance; each additional lesion (List separately in addition to code for primary procedure)", "name": "FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 68.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 71.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 74.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 77.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 79.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.15, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 91.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 97.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 105.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 110.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 111.15, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 112.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 129.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 138.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 170.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 173.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 219.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 226.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 234.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 241.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 245.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 255.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 259.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 261.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 276.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 277.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 293.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 294.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 299.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 302.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 304.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 308.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 319.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 327.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 345.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 346.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 351.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 356.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 368.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 375.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 380.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 461.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 469.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 475.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10021", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Fine needle aspiration; without imaging guidance", "name": "FNA W/O Image", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 49.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 50.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 51.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 53.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 55.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 59.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 59.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 59.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 62.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 67.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 70.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 70.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 73.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 74.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 74.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 75.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 75.56, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 76.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 76.7, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 81.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 81.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 86.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.19, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 90.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.72, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 96.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2828, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2844, 2204, 2205, 2206, 2207, 2721, 2210, 2211, 2212, 2214, 2215, 2216, 2857, 2738, 2872, 2174, 2881, 2756, 2765, 2894, 2771, 2779, 2780, 2788, 2917, 2927, 2161, 2162, 2163, 2164, 2165, 2166, 2807, 2169, 2170, 2171, 2172, 2173, 2814, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 103.31, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 104.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 106.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 110.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 111.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 111.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 113.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 115.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 115.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.09, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 121.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 129.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 129.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 130.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 131.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 139.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 140.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 142.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.93, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 144.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 150.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 150.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 153.52, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.28, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 163.12, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 163.2, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 173.4, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 175.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 178.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 191.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 201.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 254.71, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 262.35, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10030", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "", "name": "IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 111.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 115.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 123.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 129.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 131.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 140.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2707, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 141.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 154.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 162.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 167.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 168.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 175.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 178.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 178.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 185.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 186.55, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 188.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 188.76, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 190.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 194.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.11, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 210.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 213.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 215.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 216.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 217.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 228.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 229.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 232.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 250.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 267.52, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 284.24, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 285.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 287.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 288.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 290.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 334.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 447.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 476.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 520.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 528.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 537.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 563.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 564.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 573.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 596.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 599.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 600.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 602.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 610.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 611.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 625.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 650.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 651.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 678.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 691.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 695.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 705.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 705.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 717.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 720.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 733.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 747.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 751.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 752.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 760.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 763.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 782.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 804.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 807.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 814.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 846.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 848.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 877.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 880.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 903.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 912.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 912.73, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 927.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 939.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 941.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 950.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 972.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1033.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1129.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1174.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1216.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10035", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "", "name": "PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 71.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 73.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 76.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 77.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 81.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 83.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.65, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 97.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 104.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 105.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 111.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 112.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 115.38, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.64, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.96, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.13, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 134.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 135.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.56, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 142.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.16, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 177.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 178.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 179.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 183.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 321.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 343.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 348.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 372.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 375.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 395.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 400.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 416.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 429.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 436.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 436.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 443.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 444.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 465.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 472.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 472.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 484.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 500.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 502.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 503.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 513.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 524.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 524.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 536.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 545.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 546.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 552.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 554.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 555.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 556.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 557.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 581.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 591.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 592.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 604.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 606.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 625.58, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 632.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 637.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 655.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 656.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 667.28, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 671.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 683.63, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 706.89, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 708.99, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 727.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 790.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 834.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 850.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10036", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)", "name": "PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 34.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 35.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 36.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 36.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 37.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 38.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 39.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 40.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 41.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 41.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2707, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 48.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 51.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 55.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 57.85, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.53, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 60.26, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 60.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.84, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 67.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.16, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 73.48, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 74.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 86.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 90.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 267.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 285.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 290.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 309.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 322.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 328.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 344.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 357.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 360.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 364.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 375.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 381.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 384.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 387.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 404.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 407.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 419.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 420.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 430.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 432.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 443.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 448.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 453.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 454.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 467.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 469.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 480.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 481.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 482.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 484.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 498.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 509.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 511.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 524.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 543.64, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 545.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 559.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 560.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 567.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 568.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 579.88, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 599.06, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 610.79, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 616.12, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 623.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 682.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 724.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 746.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10040", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)", "name": "Acne Surgery", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 45.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 48.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 48.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 51.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 54.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 54.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 57.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 59.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 61.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 61.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 71.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 73.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 74.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 79.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 82.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "54", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2959, 2960, 158, 2975, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 2978, 2980, 2984, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 90.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 90.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "54", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 3038, 3058, 3061, 3064 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.13, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 96.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 96.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 98.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 98.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 104.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 106.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 106.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 106.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 106.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 110.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 111.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 113.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "54", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 2721, 2738, 2756, 198, 199, 200, 201, 202, 2765, 2771, 2779, 2780, 2788, 2807, 2814, 2828, 2844, 2857, 2872, 2881, 2894, 2917, 2927 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 113.05, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 113.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.28, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.4, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.05, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 123.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.8, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.16, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 131.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 131.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 134.05, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 134.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 134.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 135.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 142.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 145.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 198, 199, 200, 201, 202, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 157.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 162.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 169.57, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 174.66, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 179.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 181.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 198.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 203.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10060", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single", "name": "Drainage of Skin Abscess: Simple or Single", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 77.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 82.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 83.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 89.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 90.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 91.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 96.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 96.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 97.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 98.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.85, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 103.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 103.7, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 104.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 105.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 112.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 112.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 113.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 114.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 115.35, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 121.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 122.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 122.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 123.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 123.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 124.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 124.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 129.6, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 130.05, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 130.65, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 130.66, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 134.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 135.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 135.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.7, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 141.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 141.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 145.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 145.92, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 153.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 155.04, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.07, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 157.99, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 162.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 163.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 167.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 174.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 182.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 184.4, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 5, 6 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 186.82, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.42, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 195.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 209.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 218.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10061", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple", "name": "Drainage of Skin Abscess: Complicated or Multiple", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 141.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 151.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 154.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 162.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 164.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 2707, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 165.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 167.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 168.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 172.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 172.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 178.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 179.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 188.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 189.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 189.55, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 190.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 190.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 190.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 195.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 203.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 24, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 33, 2091, 35, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 25, 26, 27, 28, 29, 30, 31, 32, 34, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 206.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2828, 2706, 2844, 2721, 2857, 2738, 2872, 2881, 2756, 2765, 2894, 2771, 2779, 2780, 2788, 2917, 2927, 2807, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 207.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 208.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 215.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 215.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 216.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 216.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 217.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 218.4, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 220.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 221.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 223.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 224.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 232.05, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 233.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 235.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 236.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 240.18, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 240.62, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 240.83, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 241.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 242.45, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 254.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 254.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 255.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 256.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 256.88, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 261.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 269.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 271.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 272.94, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 273.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 273.99, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 274.36, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 279.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 287.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 298.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 317.58, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 5, 6 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 321.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 326.54, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 336.34, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 339.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 359.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 373.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10080", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and drainage of pilonidal cyst; simple", "name": "Drainage of Pilonidal Cyst: Simple", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 81.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 85.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 86.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 2707, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.1, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2828, 2706, 2844, 2721, 2857, 2738, 2872, 2881, 2756, 2765, 2894, 2771, 2779, 2780, 2788, 2917, 2927, 2807, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.99, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 138.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.81, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 151.05, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 159.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.12, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 165.94, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 166.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 169.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 169.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.19, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 175.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 177.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 182.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 183.2, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 185.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 186.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 186.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 191.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 194.65, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 196.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 201.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 202.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 203.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 203.62, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 208.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 209.48, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 212.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 217.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 219.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 220.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 221.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 221.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 222.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 223.44, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 226.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 226.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 228.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 229.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 232.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 235.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 235.91, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 237.23, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 237.41, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 241.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 251.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 266.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 272.02, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 5, 6 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 272.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 279.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 290.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 295.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 296.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 302.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 312.24, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 314.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 314.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 321.61, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 335.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 341.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 364.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 419.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 455.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10081", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and drainage of pilonidal cyst; complicated", "name": "Drainage of Pilonidal Cyst: Complicated", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 142.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 144.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 153.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 155.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 166.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 168.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 169.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 178.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 179.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 194.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 196.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 208.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 209.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 211.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 212.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 214.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 223.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 226.52, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 226.81, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 228.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 3075, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 119, 120, 3038, 122, 108, 109, 110, 111, 112, 113, 3058, 114, 115, 3061, 116, 117, 3064, 121, 118, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 238.06, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 242.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 244.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 249.38, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 249.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 253.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 264.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 266.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 270.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 274.69, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 279.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 279.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 280.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 280.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 281.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 282.63, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 284.8, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 286.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 287.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 288.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 293.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 294.45, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 295.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 298.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 302.6, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 305.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 312.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 313.08, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 313.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 315.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 320.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 330.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 332.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 333.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 334.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 338.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 339.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 341.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 352.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 355.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 355.32, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 356.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 356.66, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 362.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 362.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 366.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 366.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 373.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 375.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 394.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 401.05, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 418.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 427.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 433.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 444.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 453.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 462.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 462.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 479.29, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 493.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 493.67, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 578.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 617.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10120", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and removal of foreign body, subcutaneous tissues; simple", "name": "Remove Foreign Body, Simple", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 81.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 96.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 103.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.1, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.65, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 119.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 129.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 131.82, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 138.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 138.29, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 138.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 138.73, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 139.1, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 139.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 140.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 145.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 147.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 149.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 151.2, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 151.76, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.65, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.88, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 162.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 164.45, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 165.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 168.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 169.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 170.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 170.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 172.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706, 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 173.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 177.41, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 179.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 184.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 189.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 189.24, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 189.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 195.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 197.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 200.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 201.07, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 201.63, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 202.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.04, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 208.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 210.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 214.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 215.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 220.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 224.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 236.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 250.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 251.48, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 253.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 259.03, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 260.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 263.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10121", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and removal of foreign body, subcutaneous tissues; complicated", "name": "Remove Foreign Body, Complicated", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 145.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 155.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 155.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 165.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 168.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 169.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 170.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 179.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 183.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 184.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 185.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 190.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 194.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 194.65, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 195.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 195.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 196.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 197.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 207.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 212.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 212.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 213.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2706, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 214.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 224.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 224.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 226.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 227.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 229.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 230.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 232.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 239.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 243.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 246.51, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 247.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 247.98, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 248.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 249.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 251.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 253.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 259.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 259.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 268.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 268.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 270.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 273.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 275.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 283.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 284.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 284.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 285.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 286.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 287.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 288.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 290.72, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 291.84, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 291.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 292.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 294.45, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 299.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 299.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 299.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 300.8, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 302.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 307.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 309.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 310.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 310.08, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 312.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 319.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 319.6, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 319.91, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 324.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 335.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 336.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 336.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 338.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 339.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 341.24, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 345.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 348.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 359.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 361.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 362.57, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 363.23, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 364.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 368.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 372.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 376.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 384.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 390.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 399.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 426.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 449.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 453.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 461.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 465.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 470.03, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 484.13, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10140", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and drainage of hematoma, seroma or fluid collection", "name": "Drainage of Hematoma/Fluid", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 93.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 99.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 105.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 110.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 114.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 121.55, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 124.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 124.95, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 125.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 131.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 132.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 2706, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 140.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 144.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 147.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 149.48, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 152.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 153.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 154.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.48, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 159.9, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 162.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 164.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 166.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "54", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 108, 2158, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 170.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 170.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 173.85, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 175.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 175.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 179.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 184.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 184.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 185.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 185.44, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 186.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 189.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 190.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 190.24, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "54", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2828, 2844, 158, 159, 160, 2721, 161, 162, 163, 164, 165, 166, 167, 2857, 168, 169, 170, 2738, 2872, 2881, 2756, 2765, 2894, 2771, 2779, 2780, 2788, 2917, 2927, 2807, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 194.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 195.5, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 196.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 197.03, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 200.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 201.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 202.92, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 203.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 206.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 207.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 208.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 215.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 216.13, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 218.23, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 219.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 220.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 224.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 230.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 231.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 233.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 239.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 246.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 250.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 253.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 256.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 259.73, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 267.52, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 271.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 276.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 292.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 299.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10160", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Puncture aspiration of abscess, hematoma, bulla, or cyst", "name": "Puncture Drainage of Lesion", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 75.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 75.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 85.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 87.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 88.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 94.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 96.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 98.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 100.3, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.15, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 101.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2959, 2960, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2975, 2207, 2978, 2210, 2980, 2211, 2212, 2214, 2984, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 107.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 108.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 109.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 110.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 111.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 116.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 117.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 118.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 119.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 120.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775, 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 121.23, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 126.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.19, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 127.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.05, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.28, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 128.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 130.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 133.9, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 134.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 135.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 135.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2828, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2844, 2204, 2205, 2206, 2207, 2721, 2210, 2211, 2212, 2214, 2215, 2216, 2857, 2738, 2872, 2174, 2881, 2756, 2765, 2894, 2771, 2779, 2780, 2788, 2917, 2927, 2161, 2162, 2163, 2164, 2165, 2166, 2807, 2169, 2170, 2171, 2172, 2173, 2814, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 136.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 139.1, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "53", "54", "55", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 141.08, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 143.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.9, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 147.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 147.2, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 147.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 150.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 150.48, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 151.76, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 154.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 156.4, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 157.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 158.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 159.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 159.89, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "53", "54", "55", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.88, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 164.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 165.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 169.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.74, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 172.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 172.58, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 180.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 184.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 188.1, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 197.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 200.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 202.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 206.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 210.6, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 5, 6 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 214.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "53", "54", "55", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 217.33, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 221.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 223.85, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 226.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "10180", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Incision and drainage, complex, postoperative wound infection", "name": "Complex Drainage Wound", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 137.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 138.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 146.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 147.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 148.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 157.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 159.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 160.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 161.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 162.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 171.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 172.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 175.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 176.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 181.9, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 183.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 183.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 185.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 186.15, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 187.85, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 189.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 192.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 197.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 199.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 202.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 202.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 204.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 214.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 216.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 219.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 220.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 221.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 221.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 224.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 227.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 233.39, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 235.31, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 236.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 239.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 239.85, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 240.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 241.15, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 241.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 242.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 245.38, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 252.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 253.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 254.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 255.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 256.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2721, 2738, 2756, 2765, 2771, 2779, 2780, 2788, 2807, 2814, 2828, 2844, 2857, 2872, 2881, 2894, 2917, 2927, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 256.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 257.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 264.34, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 265.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 267.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 269.6, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 272.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 276.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 276.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 278.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 279.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 280.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 281.96, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 283.13, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 286.45, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 288.56, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 291.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 291.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 295.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 295.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 299.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 299.58, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 302.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 302.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 303.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 303.67, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 306.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 307.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 309.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 310.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 320.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 322.21, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 322.78, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 327.04, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 329.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 336.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 337.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 348.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 352.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 359.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 369.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 371.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 372.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 377.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 378.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 384.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 388.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 404.84, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 408.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 412.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 416.99, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 449.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 465.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "11000", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Debridement of extensive eczematous or infected skin; up to 10% of body surface", "name": "Debride Infected Skin", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 23.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 24.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 24.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 25.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 26.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 27.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 27.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 29.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 29.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 30.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 31.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 31.45, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 32.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 34.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 35.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 36.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 37.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 38.19, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 38.35, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 39.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 39.07, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 39.26, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 42.04, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 42.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 43.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.06, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 44.84, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 45.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 45.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 46.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.2, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.64, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 48.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 49.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 49.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 50.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 51.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 52.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 53.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 54.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 54.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 55.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.05, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 56.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 57.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 57.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 57.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 58.75, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 59.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 59.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 60.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 61.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 62.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 63.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 63.41, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 63.7, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 64.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 65.91, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 66.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 67.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 67.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 67.64, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 68.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2546, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 68.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 69.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 71.87, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.53, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 72.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 73.35, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 73.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 76.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 78.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 80.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 81.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 84.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 90.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 91.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 92.32, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 95.09, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 98.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 102.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "11001", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Debridement of extensive eczematous or infected skin; each additional 10% of the body surface, or part thereof (List separately in addition to code for primary procedure)", "name": "Debride Infected Skin Add-on", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 11.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 12.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2978, 3075, 2980, 2984, 2959, 2960, 3058, 3061, 3064, 3038, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 12.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 13.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 13.6, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 14.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 15.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 15.3, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 16.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 17.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 17.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 18.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 18.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 19.4, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "55", "56", "61" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 19.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "55", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 19.52, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 20.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 20.15, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 20.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 21.38, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 21.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 22.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2959, 2960, 158, 159, 160, 161, 2978, 162, 2980, 163, 164, 165, 2984, 166, 167, 168, 169, 170, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 22.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 22.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 22.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 23.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 23.25, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 23.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 24.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 3038, 3058, 3061, 3064 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 24.23, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 24.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 24.8, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 24.94, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 25.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 26.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 26.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2544, 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2535, 2536, 2537, 2521, 2540, 2525, 2526, 2527, 2528, 2529, 2531, 2533, 2534, 2513, 2514, 2515, 2516, 2005, 2517, 2007, 2008, 2518, 2010, 2011, 2012, 2013, 2014, 2015, 2519, 2017, 2018, 2522, 2523, 2021, 2022, 2023, 2024, 2025, 2026, 2530, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2538, 2539, 2037, 2038, 2542, 2543, 2041, 2545, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 26.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 27.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "53", "54", "55", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 27.95, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.05, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2546, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.26, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.5, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.66, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.77, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 28.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 30.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 2721, 2738, 2756, 198, 199, 200, 201, 202, 2765, 2771, 2779, 2780, 2788, 2807, 2814, 2828, 2844, 2857, 2872, 2881, 2894, 2917, 2927 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 30.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 31.0, "negotiated_type": "fee schedule", "service_code": [ "21", "22", "23", "24", "26", "31", "34", "41", "42", "51", "52", "53", "56", "61" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 32.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 33.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506, 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 33.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 34.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 35.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 35.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 36.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 37.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 40.41, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 41.63, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 43.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "25", "32", "33", "49", "50", "54", "55", "57", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 47.08, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 32, 33, 34, 35, 24, 25, 26, 27, 28, 29, 30, 31 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "11004", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum", "name": "Debride Genetalia & Perenium", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 450.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 456.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 477.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 480.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 487.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 508.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 516.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 524.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 532.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 532.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 550.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 568.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 576.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 583.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 584.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 600.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 603.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 609.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 612.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 617.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 619.65, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 627.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 628.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 636.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 643.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 655.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 665.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 673.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 673.6, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 688.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 690.41, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 710.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 715.7, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 720.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 723.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 725.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 729.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 736.44, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 742.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 763.78, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 772.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 773.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 775.52, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 782.47, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 792.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 842.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 920.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 965.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 967.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 990.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1090.55, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1123.26, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "11005", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure", "name": "Debride Abdominal Wall", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 601.5, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 611.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 641.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 642.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 652.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 684.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 696.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 700.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 711.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 711.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 742.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 758.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 770.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 783.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 788.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 802.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 805.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 815.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 818.55, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 829.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 832.15, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 850.85, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 856.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 858.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 872.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 875.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 879.45, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 120, 121, 122, 123, 124, 125, 126, 127 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 889.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 904.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2706 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 926.5, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 928.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 934.8, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2507, 2508, 2509, 2510, 2511, 2512 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 948.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 963.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 979.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1157, 1158, 1159, 1160, 1161, 1162, 1163, 1164, 1165, 1166, 1167, 1168, 1169, 1170, 1171, 1172, 1173, 1174, 1175, 1176, 1177, 1178, 1179, 1180, 1181, 1182, 1183, 1184, 1185, 1186, 1187, 1188, 1189, 1190, 1191, 1192, 1193, 1194, 1195, 1196, 1197, 1198, 1199, 1200, 1201, 1202, 1203, 1204, 1205, 1206, 1207, 1208, 1209, 1210, 1211, 1212, 1213, 1214, 1215, 1216, 1217, 1218, 1219, 1220, 1221, 1222, 1223, 1224, 1225, 1226, 1227, 1228, 1229, 1230, 1231, 1232, 1233, 1234, 1235, 1236, 1237, 1238, 1239, 1240, 1241, 1242, 1243, 1244, 1245, 1246, 1247, 1248, 1249, 1250, 1251, 1252, 1253, 1254, 1255, 1256, 1257, 1258, 1259, 1260, 1261, 1262, 1263, 1264, 1265, 1266, 1267, 1268, 1269, 1270, 1271, 1272, 1273, 1274, 1275, 1276, 1277, 1278, 1279, 1280, 1281, 1282, 1283, 1284, 1285, 1286, 1287, 1288, 1289, 1290, 1291, 1292, 1293, 1294, 1295, 1296, 1297, 1298, 1299, 1300, 1301, 1302, 1303, 1304, 1305, 1306, 1307, 1308, 1309, 1310, 1311, 1312, 1313, 1314, 1315, 1316, 1317, 1318, 1319, 1320, 1321, 1322, 1323, 1324, 1325, 1326, 1327, 1328, 1329, 1330, 1331, 1332, 1333, 1334, 1335, 1336, 1337, 1338, 1339, 1340, 1341, 1342, 1343, 1344, 1345, 1346, 1348, 1349, 1350, 1351, 1352, 1353, 1354, 1355, 1356, 1357, 1358, 1359, 1360, 1361, 1362, 1363, 1364, 1365, 1366, 1367, 1368, 1369, 1370, 1371, 1372, 1373, 1374, 1375, 1376, 1377, 1378, 1379, 1381, 1382, 1383, 1384, 1385, 1386, 1387, 1388, 1389, 1390, 1391, 1392, 1393, 1394, 1396, 1397, 1398, 1399, 1400, 1401, 1402, 1403, 1404, 1405, 1406, 1407, 1408, 1409, 1410, 1411, 1412, 1413, 1414, 1415, 1416, 1417, 1418, 1419, 1420, 1421, 1422, 1423, 1424, 1425, 1426, 1427, 1429, 1430, 1431, 1432, 1433, 1434, 1435, 1436, 1437, 1438, 1439, 1440, 1441, 1442, 1443, 1444, 1445, 1446, 1447, 1448, 1449, 1451, 1452, 1453, 1454, 1455, 1456, 1457, 1458, 1459, 1460, 1461, 1462, 1463, 1464, 1465, 1466, 1467, 1468, 1469, 1470, 1471, 1472, 1473, 1474, 1475, 1476, 1477, 1478, 1479, 1480, 1481, 1482, 1483, 1484, 1485, 1486, 1487, 1488, 1489, 1490, 1491, 1492, 1493, 1494, 1495, 1496, 1497, 1498, 1499, 1500, 1501, 1502, 1503, 1504, 1505, 1506, 1507, 1508, 1509, 1510, 1511, 1512, 1513, 1514, 1515, 1516, 1517, 1518, 1519, 1520, 1521, 1522, 1523, 1524, 1525, 1526, 1527, 1528, 1529, 1530, 1531, 1532, 1533, 1534, 1535, 1536, 1537, 1538, 1539, 1540, 1541, 1542, 1543, 1544, 1545, 1546, 1547, 1548, 1549, 1550, 1551, 1552, 1553, 1554, 1555, 1556, 1557, 1558, 1559, 1560, 1561, 1562, 1563, 1564, 1565, 1566, 1567, 1568, 1569, 1570, 1571, 1572, 1573, 1574, 1575, 1576, 1577, 1578, 1579, 1580, 1581, 1582, 1583, 1584, 1585, 1586, 1587, 1588, 1589, 1590, 1591, 1592, 1593, 1594, 1595, 1596, 1597, 1598, 1599, 1600, 1601, 1602, 1603, 1604, 1605, 1606, 1607, 1608, 1609, 1610, 1611, 1612, 1613, 1614, 1615, 1616, 1617, 1618, 1619, 1620, 1622, 1623, 1624, 1625, 1626, 1627, 1628, 1629, 1630, 1631, 1632, 1633, 1634, 1635, 1636, 1637, 1638, 1639, 1640, 1641, 1642, 1643, 1644, 1645, 1646, 1647, 1648, 1649, 1650, 1651, 1652, 1653, 1654, 1655, 1656, 1657, 1658, 1659, 1660, 1661, 1662, 1663, 1664, 1665, 1666, 1668, 1669, 1670, 1671, 1672, 1673, 1674, 1675, 1676, 1677, 1678, 1679, 1680, 1681, 1682, 1683, 1684, 1685, 1686, 1687, 1688, 1689, 1690, 1691, 1692, 1693, 1694, 1695, 1696, 1697, 1698, 1699, 1700, 1701, 1702, 1703, 1704, 1705, 1706, 1707, 1708, 1709, 1710, 1711, 1712, 1713, 1714, 1715, 1716, 1717, 1718, 1719, 1720, 1721, 1722, 1723, 1724, 1725, 1726, 1727, 1728, 1729, 1730, 1731, 1732, 1733, 1734, 1735, 1770, 1773, 1775 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 981.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 990.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 997.12, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2513, 2514, 2515, 2516, 2517, 2518, 2519, 2521, 2522, 2523, 2525, 2526, 2527, 2528, 2529, 2530, 2531, 2533, 2534, 2535, 2536, 2537, 2538, 2539, 2540, 2542, 2543, 2544, 2545 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1014.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 158, 159 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1019.93, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1037.3, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 785, 786, 787, 788, 789, 790, 791, 792, 793, 794, 795, 796, 797, 798, 799, 800, 801, 803, 804, 805, 806, 807, 808, 809, 810, 811, 812, 813, 814, 815, 816, 817, 818, 819, 820, 821, 822, 824, 825, 826, 827, 828, 829, 830, 831, 832, 833, 834, 835, 836, 837, 838, 839, 840, 841, 842, 843, 844, 845, 846, 847, 848, 849, 850, 851, 852, 853, 854, 855, 856, 857, 858, 859, 860, 861, 862, 863, 864, 865, 866, 867, 868, 869, 870, 871, 872, 873, 874, 875, 876, 877, 878, 879, 880, 881, 882, 883, 884, 885, 886, 887, 888, 889, 890, 891, 892, 893, 894, 895, 896, 897, 898, 899, 900, 901, 902, 903, 904, 905, 907, 908, 909, 910, 911, 912, 913, 914, 915, 916, 917, 918, 919, 920, 921, 922, 924, 925, 926, 927, 928, 929, 930, 931, 932, 933, 934, 935, 936, 938, 939, 940, 941, 942, 943, 944, 945, 946, 947, 948, 949, 950, 951, 952, 953, 954, 955, 957, 958, 959, 960, 961, 962, 963, 964, 965, 966, 967, 968, 969, 970, 971, 972, 973, 975, 976, 977, 978, 979, 980, 981, 982, 983, 984, 985, 986, 987, 988, 989, 990, 991, 992, 993, 994, 995, 996, 997, 998, 999, 1000, 1001, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, 1010, 1011, 1012, 1013, 1014, 1015, 1016, 1017, 1018, 1019, 1020, 1021, 1022, 1023, 1024, 1025, 1026, 1027, 1028, 1029, 1030, 1031, 1032, 1033, 1034, 1035, 1036, 1037, 1038, 1039, 1040, 1041, 1042, 1044, 1045, 1046, 1047, 1048, 1049, 1050, 1051, 1052, 1053, 1054, 1055, 1056, 1057, 1058, 1059, 1060, 1061, 1062, 1063, 1064, 1065, 1066, 1067, 1068, 1069, 1070, 1071, 1072, 1073, 1074, 1075, 1076, 1077, 1078, 1079, 1081, 1082, 1083, 1084, 1085, 1086, 1087, 1088, 1089, 1090, 1091, 1092, 1093, 1094, 1095, 1096, 1097, 1098, 1099, 1100, 1101, 1102, 1103, 1104, 1105, 1106, 1107, 1108, 1109, 1110, 1111, 1112, 1113, 1114, 1115, 1116, 1117, 1118, 1119, 1120, 1121, 1122, 1124, 1125, 1126, 1127, 1128, 1129, 1130, 1131, 1132, 1133, 1134, 1135, 1136, 1137, 1138, 1139, 1140, 1141, 1142, 1143, 1144, 1145 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1047.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1056.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1059.44, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2546 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1082.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1090.0, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1246.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52" ] } ], "provider_references": [ 2236, 2237, 2238, 2239, 2240, 2241, 2242, 2243, 2244, 2245, 2246, 2247, 2248, 2249, 2250, 2251, 2252, 2253, 2254, 2255, 2256, 2257, 2258, 2260, 2261, 2262, 2263, 2264, 2265, 2266, 2267, 2268, 2269, 2270, 2271, 2272, 2273, 2274, 2275, 2276, 2277, 2278, 2279, 2280, 2281, 2282, 2283, 2284, 2285, 2286, 2287, 2288, 2289, 2290, 2291, 2292, 2293, 2294, 2295, 2296, 2297, 2298, 2299, 2300, 2301, 2302, 2303, 2304, 2305, 2306, 2307, 2308, 2309, 2310, 2311, 2312, 2313, 2314, 2315, 2316, 2317, 2318, 2319, 2320, 2321, 2322, 2323, 2324, 2325, 2326, 2327, 2328, 2329, 2330, 2331, 2332, 2333, 2334, 2335, 2336, 2337, 2338, 2339, 2340, 2341, 2342, 2343, 2344, 2345, 2346, 2348, 2349, 2350, 2351, 2352, 2353, 2354, 2355, 2356, 2357, 2358, 2359, 2360, 2361, 2362, 2363, 2364, 2365, 2366, 2367, 2368, 2369, 2370, 2371, 2372, 2373, 2374, 2375, 2376, 2377, 2378, 2379, 2380, 2381, 2382, 2383, 2384, 2385, 2386, 2388, 2389, 2390, 2391, 2392, 2393, 2394, 2395, 2396, 2397, 2398, 2399, 2400, 2401, 2402, 2404, 2405, 2406, 2407, 2408, 2409, 2410, 2411, 2412, 2413, 2414, 2415, 2416, 2417, 2418, 2419, 2420, 2421, 2422, 2423, 2424, 2425, 2426, 2427, 2428, 2429, 2430, 2431, 2432, 2433, 2434, 2435, 2436, 2437, 2438, 2439, 2440, 2441, 2442, 2443, 2444, 2445, 2446, 2447, 2448, 2449, 2450, 2451, 2452, 2453, 2454, 2455, 2456, 2457, 2458, 2459, 2460, 2461, 2462, 2463, 2464, 2465, 2466, 2467, 2468, 2469, 2470, 2471, 2472, 2473, 2474, 2475, 2476, 2477, 2478, 2479, 2480, 2481, 2482, 2483, 2484, 2485, 2486, 2487, 2488, 2489, 2490, 2491, 2492, 2493, 2494, 2495, 2496, 2497, 2498, 2499, 2500, 2501, 2502, 2503, 2504, 2505, 2506 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1309.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1320.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1353.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 198, 199, 200, 201, 202 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1464.24, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 1508.17, "negotiated_type": "fee schedule", "service_code": [] } ], "provider_references": [ 768, 769, 770, 771, 772, 773, 774, 775, 776, 777, 778, 779, 780, 781, 782, 783, 784, 747, 748, 749, 750, 751, 752, 753, 754, 755, 756, 757, 758, 759, 760, 761, 762, 763, 764, 765, 766, 767 ] } ], "negotiation_arrangement": "ffs" }, { "billing_code": "11006", "billing_code_type": "CPT", "billing_code_type_version": "2023", "description": "Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure", "name": "Debride Genetalia/Perenium/Abdominal Wall", "negotiated_rates": [ { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 549.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 555.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 584.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2978, 2980, 2984, 2959, 2960, 2975 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 585.6, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 592.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 623.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 3075, 3058, 3061, 3064, 3038 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 633.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 638.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 646.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "57", "58", "59", "60", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2707 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 648.75, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 1782, 1783, 1784, 1785, 1786, 1787, 1788, 1789, 1790, 1791, 1792, 1794, 1795, 1796, 1797, 1798, 1799, 1800, 1801, 1802, 1803, 1804, 1805, 1806, 1807, 1808, 1809, 1810, 1811, 1812, 1813, 1814, 1815, 1816, 1817, 1818, 1821, 1822, 1823, 1824, 1825, 1827, 1828, 1829, 1830, 1831, 1832, 1833, 1834, 1835, 1836, 1837, 1839, 1841, 1842, 1843, 1844, 1845, 1846, 1847, 1848, 1849, 1850, 1851, 1853, 1854, 1855, 1856, 1857, 1858, 1859, 1860, 1861, 1862, 1863, 1864, 1865, 1866, 1867, 1868, 1869, 1870, 1871, 1872, 1873, 1874, 1875, 1876, 1877, 1878, 1879, 1880, 1881, 1882, 1883, 1884, 1885, 1886, 1887, 1888, 1889, 1890, 1891, 1892, 1893, 1894, 1895, 1896, 1897, 1898, 1899, 1900, 1901, 1902, 1903, 1904, 1905, 1906, 1907, 1908, 1909, 1910, 1911, 1912, 1913, 1914, 1915, 1916, 1917, 1918, 1919, 1920, 1921, 1922, 1923, 1924, 1925, 1926, 1927, 1928, 1929, 1930, 1931, 1932, 1933, 1934, 1935, 1936, 1937, 1938, 1939, 1940, 1941, 1942, 1943, 1948, 1958, 1960 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 675.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 692.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 700.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 707.2, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2050, 2052, 2055, 2057, 2059, 2061, 2062, 2063, 2065, 2066, 2067, 2068, 2069, 2070, 2072, 2073, 2074, 2075, 2076, 2078, 2079, 2080, 2081, 2082, 2083, 2084, 2085, 2086, 2087, 2088, 2089, 2091, 2093, 2094, 2095, 2098, 2099, 2100, 2101, 2102, 2103, 2104, 2107, 2108, 2109, 2111, 2113, 2114, 2116, 2117, 2118, 2119, 2120, 2121, 2122, 2123, 2124, 2125, 2126, 2127, 2130, 2131, 2132, 2133, 2135, 2136, 2137, 2138, 2139, 2141, 2142, 2144, 2145, 2146, 2148, 2149, 2150, 2151, 2152, 2153, 2154, 2155, 2156, 2158, 2005, 2007, 2008, 2010, 2011, 2012, 2013, 2014, 2015, 2017, 2018, 2021, 2022, 2023, 2024, 2025, 2026, 2028, 2029, 2030, 2031, 2032, 2033, 2034, 2037, 2038, 2041, 2043, 2044, 2045, 2046, 2047 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 717.4, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2176, 2177, 2178, 2180, 2181, 2182, 2185, 2186, 2187, 2188, 2189, 2190, 2191, 2192, 2193, 2195, 2197, 2198, 2201, 2202, 2203, 2204, 2205, 2206, 2207, 2210, 2211, 2212, 2214, 2215, 2216, 2161, 2162, 2163, 2164, 2165, 2166, 2169, 2170, 2171, 2172, 2173, 2174, 2175 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 732.0, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55", "56", "57", "58", "59", "60", "61", "62", "65", "71", "72", "81", "99" ] } ], "provider_references": [ 2721, 2881, 2756, 2788, 2844, 2917, 2857, 2828, 2765, 2894, 2927, 2738, 2771, 2807, 2872, 2779, 2780, 2814 ] }, { "negotiated_prices": [ { "billing_class": "institutional", "billing_code_modifier": [], "expiration_date": "2024-01-01", "negotiated_rate": 735.25, "negotiated_type": "fee schedule", "service_code": [ "01", "02", "03", "04", "05", "06", "07", "08", "09", "10", "11", "12", "13", "14", "15", "16", "17", "18", "19", "20", "21", "22", "23", "24", "25", "26", "31", "32", "33", "34", "41", "42", "49", "50", "51", "52", "53", "54", "55",