{"reporting_entity_name":"Healthfirst Insurance Company","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-09-24","version":"2.0.0","provider_references":[{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003294307],"tin":{"type":"npi","value":"1003294307"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013360528],"tin":{"type":"npi","value":"1013360528"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003691064],"tin":{"type":"npi","value":"1003691064"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013154657],"tin":{"type":"npi","value":"1013154657"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043079064],"tin":{"type":"npi","value":"1043079064"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1023503927],"tin":{"type":"npi","value":"1023503927"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1023381100],"tin":{"type":"npi","value":"1023381100"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013291335],"tin":{"type":"npi","value":"1013291335"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043374853],"tin":{"type":"npi","value":"1043374853"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073689600],"tin":{"type":"npi","value":"1073689600"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1073947727],"tin":{"type":"npi","value":"1073947727"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013292002],"tin":{"type":"npi","value":"1013292002"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043663107],"tin":{"type":"npi","value":"1043663107"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1013902303],"tin":{"type":"npi","value":"1013902303"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1316446586],"tin":{"type":"npi","value":"1316446586"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1316049240],"tin":{"type":"npi","value":"1316049240"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1316681430],"tin":{"type":"npi","value":"1316681430"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326519612],"tin":{"type":"npi","value":"1326519612"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326525338],"tin":{"type":"npi","value":"1326525338"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326662008],"tin":{"type":"npi","value":"1326662008"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326702317],"tin":{"type":"npi","value":"1326702317"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326768862],"tin":{"type":"npi","value":"1326768862"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1326817693],"tin":{"type":"npi","value":"1326817693"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1336113398],"tin":{"type":"npi","value":"1336113398"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1336650688],"tin":{"type":"npi","value":"1336650688"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1336984178],"tin":{"type":"npi","value":"1336984178"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346629995],"tin":{"type":"npi","value":"1346629995"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1346760196],"tin":{"type":"npi","value":"1346760196"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1356310890],"tin":{"type":"npi","value":"1356310890"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1649578949],"tin":{"type":"npi","value":"1649578949"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1649516352],"tin":{"type":"npi","value":"1649516352"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1649587627],"tin":{"type":"npi","value":"1649587627"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1649837113],"tin":{"type":"npi","value":"1649837113"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659061489],"tin":{"type":"npi","value":"1659061489"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659534907],"tin":{"type":"npi","value":"1659534907"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659754885],"tin":{"type":"npi","value":"1659754885"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1659822963],"tin":{"type":"npi","value":"1659822963"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669470019],"tin":{"type":"npi","value":"1669470019"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669636577],"tin":{"type":"npi","value":"1669636577"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669873071],"tin":{"type":"npi","value":"1669873071"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1669912341],"tin":{"type":"npi","value":"1669912341"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679003404],"tin":{"type":"npi","value":"1679003404"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679295166],"tin":{"type":"npi","value":"1679295166"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1679358873],"tin":{"type":"npi","value":"1679358873"}}]},{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962716050],"tin":{"type":"npi","value":"1962716050"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962823328],"tin":{"type":"npi","value":"1962823328"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1962932871],"tin":{"type":"npi","value":"1962932871"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972059467],"tin":{"type":"npi","value":"1972059467"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972643492],"tin":{"type":"npi","value":"1972643492"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972681484],"tin":{"type":"npi","value":"1972681484"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1972944080],"tin":{"type":"npi","value":"1972944080"}}]},{"provider_group_id":8,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982417119],"tin":{"type":"npi","value":"1982417119"}}]},{"provider_group_id":9,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1982758066],"tin":{"type":"npi","value":"1982758066"}}]},{"provider_group_id":10,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992247571],"tin":{"type":"npi","value":"1992247571"}}]},{"provider_group_id":11,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1992486484],"tin":{"type":"npi","value":"1992486484"}}]},{"provider_group_id":12,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":13,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1194098251],"tin":{"type":"npi","value":"1194098251"}}]},{"provider_group_id":14,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1043079064],"tin":{"type":"npi","value":"1043079064"}}]},{"provider_group_id":15,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1609946821],"tin":{"type":"npi","value":"1609946821"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1201.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1304.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.41,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86041","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87564","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83521","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87484","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49592","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90963","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93586","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.54,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37286","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99215","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87428","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.75,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64467","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90965","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82653","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55714","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33509","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76987","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36420","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0220","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38225","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99348","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33903","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90958","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6555","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85007","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82274","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86701","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0052A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0141A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92570","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37278","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96372","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87182","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85651","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81517","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87088","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37257","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85004","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87076","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83036","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33900","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"79470","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90847","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81025","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"T1013","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69729","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31243","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82948","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43497","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27713","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92555","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86381","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94014","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99383","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93585","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69719","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37293","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"M0221","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87210","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76988","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62330","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0111A","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81000","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90460","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.1,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70471","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87478","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99349","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.72,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80504","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80061","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.39,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90960","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33278","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86231","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87494","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99381","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0073A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4605","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0092A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99396","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0171A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95117","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99395","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49595","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93152","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99203","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"47384","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93595","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86363","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1315.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90785","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87469","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86052","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85027","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0112A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66989","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93574","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92945","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64596","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99343","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33894","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37271","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0113A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86042","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.97,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55868","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64584","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92930","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86037","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86015","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37291","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87593","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61891","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37261","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78608","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70473","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55713","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33279","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99394","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80505","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49623","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55869","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22836","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97007","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63053","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93593","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33268","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37285","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43291","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90964","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37263","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37264","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37296","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49617","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33901","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0121A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49615","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6580","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55708","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55710","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99442","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99350","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33277","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"67516","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49190","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90961","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93010","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81001","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90970","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87626","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55711","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90967","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37274","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93151","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49616","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0051A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49613","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94664","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93575","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80503","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85041","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76883","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92137","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22838","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93597","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90836","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87594","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37266","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87523","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90957","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37272","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55707","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33269","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95115","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90969","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37270","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33902","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27458","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37283","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55712","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"68841","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96548","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64583","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82465","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92920","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99397","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.56,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60661","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87627","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64582","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86043","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0053A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86053","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33276","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99344","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0082A","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0083A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86364","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99342","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52284","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"15778","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99243","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93153","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37281","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83655","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.29,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69728","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78491","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1032.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92568","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0041A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90838","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33280","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37256","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37254","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37255","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0164A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97009","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64473","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49621","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0459","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90954","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37269","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37297","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94013","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37280","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99242","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64469","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91125","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37288","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99391","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.73,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"31242","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.42,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92540","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94060","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33281","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37282","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76989","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36836","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"92928","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49187","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90792","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.22,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85013","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33882","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"25448","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90955","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.52,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93596","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85018","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93584","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99341","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.5,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6576","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4287","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90968","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99214","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93569","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"58580","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99212","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52597","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86780","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93319","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64598","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33267","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37295","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0093A","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82166","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33897","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37260","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87070","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.33,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0552","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93594","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36405","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.12,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33370","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92587","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH","95"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37289","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"76984","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99382","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64474","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99393","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99205","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.59,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55867","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92081","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86036","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"70472","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64466","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"42975","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96116","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49618","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93150","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"78492","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1201.9,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82270","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37290","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37292","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83876","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81002","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37265","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80506","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87075","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0172A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86318","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55715","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69727","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"96547","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86480","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.98,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"55709","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.79,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99386","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.71,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"99459","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"91124","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64728","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"43290","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83013","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.26,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94011","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6583","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93587","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85014","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.01,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87077","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86366","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49593","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94015","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.58,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93598","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","26"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33895","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49186","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.16,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["26","TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94016","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0142A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61889","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90472","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86596","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99204","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.57,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37275","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4238","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","NU","RR","MS"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93896","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64468","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87426","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.03,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81003","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"27278","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0109","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.09,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37287","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99401","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.63,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"81007","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.48,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49591","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37294","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37258","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"97008","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0012A","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87811","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.17,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0108","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.74,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22860","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"30469","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99347","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.38,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86850","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.3,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86051","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49188","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"60660","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"22837","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92551","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"36837","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90846","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.35,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86305","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.69,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49596","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49189","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"80220","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"U0002","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.61,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94012","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.88,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99392","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0173A","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99385","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93588","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93000","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90966","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.68,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37299","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"83529","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87880","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"52443","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"98016","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99213","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"93573","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97804","name":"UNK","description":"UNK","cbsa":"28880","date_of_service":"2026-09-02","locality":"1320203","zip":"10910","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.84,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37268","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85032","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61715","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37279","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87181","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"38228","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63052","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94625","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86403","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87183","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37277","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90951","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.15,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99387","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.67,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"63032","name":"UNK","description":"UNK","cbsa":"15380","date_of_service":"2026-09-02","locality":"1328299","zip":"14001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69730","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90833","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.24,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99345","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.76,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"82947","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.34,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37259","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"64597","name":"UNK","description":"UNK","cbsa":"28740","date_of_service":"2026-09-02","locality":"1320203","zip":"12401","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[13]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37276","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0002A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0091A","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"94626","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37262","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90471","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.78,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99384","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37273","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0042A","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69726","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0081A","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49594","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95905","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.91,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49614","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"61892","name":"UNK","description":"UNK","cbsa":"35004","date_of_service":"2026-09-02","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33287","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37284","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85025","name":"UNK","description":"UNK","cbsa":"48060","date_of_service":"2026-09-02","locality":"1328299","zip":"13601","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[15]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87110","name":"UNK","description":"UNK","cbsa":"21300","date_of_service":"2026-09-02","locality":"1328299","zip":"14814","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87468","name":"UNK","description":"UNK","cbsa":"35614","date_of_service":"2026-09-02","locality":"1320201","zip":"10001","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[14]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"UNK","description":"UNK","cbsa":"45060","date_of_service":"2026-09-02","locality":"1328299","zip":"13020","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH","TC"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"62331","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"86258","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"49622","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"87086","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.86,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"35602","name":"UNK","description":"UNK","cbsa":"40380","date_of_service":"2026-09-02","locality":"1328299","zip":"13143","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"85610","name":"UNK","description":"UNK","cbsa":"10580","date_of_service":"2026-09-02","locality":"1328299","zip":"12007","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"66991","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"84433","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"33288","name":"UNK","description":"UNK","cbsa":"27060","date_of_service":"2026-09-02","locality":"1328299","zip":"13053","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37298","name":"UNK","description":"UNK","cbsa":"46540","date_of_service":"2026-09-02","locality":"1328299","zip":"13054","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"37267","name":"UNK","description":"UNK","date_of_service":"2026-09-02","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[9]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[11]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[3]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[10]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[8]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36406","name":"UNK","description":"UNK","cbsa":"24020","date_of_service":"2026-09-02","locality":"1328299","zip":"12028","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.08,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"69716","name":"UNK","description":"UNK","cbsa":"13780","date_of_service":"2026-09-02","locality":"1328299","zip":"13732","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"0174A","name":"UNK","description":"UNK","cbsa":"33","date_of_service":"2026-09-02","locality":"1328299","zip":"12010","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"institutional","setting":"outpatient","service_code":["99"],"billing_code_modifier":["TH"]}],"provider_references":[12]}]}]}
