{"hospital_name":"New York Eye and Ear Infirmary of Mount Sinai","last_updated_on":"2026-04-01","version":"3.0.0","location_name":["New York Eye and Ear Infirmary of Mount Sinai"],"hospital_address":["310 East 14th Street, New York, NY 10003"],"license_information":{"license_number":"7002026H","state":"NY"},"type_2_npi":["1740940444"],"attestation":{"attestation":"To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.","confirm_attestation":true,"attester_name":"Brent Estes"},"financial_aid_policy":["Mount Sinai has a 10% discount on gross charges for the discount cash price."],"modifier_information":[{"description":"Right side (used to identify procedures performed on the right side of the body)","code":"RT","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Left side (used to identify procedures performed on the left side of the body)","code":"LT","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Bilateral Procedure","code":"50","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Skin substitute not used as a graft","code":"JD","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples)","code":"FB","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Investigational clinical service provided in a clinical research study that is in an approved clinical research study","code":"Q0","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes","code":"TB","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit","code":"GY","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Excepted service provided at an off-campus, outpatient, provider-based department of a hospital","code":"PO","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Reduced Services","code":"52","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient speech language pathology plan of care","code":"GN","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient physical therapy plan of care","code":"GP","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Technical Component; represents the costs of equipment, supplies, and technician personnel for a procedure, excluding the physician's interpretation. It is used when only the technical portion of a test is billed, typically by hospitals, imaging centers, or independent diagnostic testing facilities","code":"TC","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Healthfirst Medicare INN/ONN - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"HealthFirst","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Humana Medicare-NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Preferred","description":"The modified price is presented in the standard charge value."},{"payer_name":"MagnaCare","plan_name":"MagnaCare Standard","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"Metroplus Exchange - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"MetroPlus","plan_name":"MetroPlus Medicare Adv - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Oscar Commercial - Ind Members - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oxford","plan_name":"Oxford Commercial - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"United Healthcare","plan_name":"United Healthcare - All Payer - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Medicare Advantage - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"VNS","plan_name":"VNS Select Health Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 1 & 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare EP 3 & 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicaid/CHP - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"WellCare","plan_name":"Wellcare Medicare/FIDA - NYEE","description":"The modified price is presented in the standard charge value."}]},{"description":"Clia waived test","code":"QW","modifier_payer_information":[{"payer_name":"1199 SEIU","plan_name":"1199 SEIU - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna HMO/PPO/POS Commercial  - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Aetna Signature Administrators/TPA - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Affinity","plan_name":"Affinity Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna - Medicare Advantage - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna HMO/OAP - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Cigna PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Elderplan","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem GHI/HIP PPO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem HIP/GHI HMO COMM - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Emblem Medicaid - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Emblem","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Access Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Blue Priority PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Connection Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - HMO/EPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - Individual Network - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Empire BC - PPO - NYEEI","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire","plan_name":"Medicare Advantage","description":"The modified price is presented in the standard charge value."},{"payer_name":"Empire Healthplus","plan_name":"Medicaid","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 1 - 2 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis EP 3 - 4 - NYEE","description":"The modified price is presented in the standard charge value."},{"payer_name":"Fidelis","plan_name":"Fidelis Medicaid - 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Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"}]},{"description":"MONAURAL DISPENSING - RESTOCK","code_information":[{"code":"55614015","type":"CDM"},{"code":"271","type":"RC"},{"code":"V5241","type":"HCPCS"}],"standard_charges":[{"gross_charge":400.0,"discounted_cash":360.0,"setting":"both","modifier_code":["GY"],"billing_class":"facility","additional_generic_notes":"The modified price is presented in the standard charge value. | Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract 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Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"}]},{"description":"EAR MOLD (MUSICIAN) each","code_information":[{"code":"55614020","type":"CDM"},{"code":"271","type":"RC"},{"code":"V5264","type":"HCPCS"}],"standard_charges":[{"gross_charge":150.0,"discounted_cash":135.0,"setting":"both","modifier_code":["GY"],"billing_class":"facility","additional_generic_notes":"The modified price is presented in the standard charge value. | Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"}]},{"description":"EAR IMPRESSION 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Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"}]},{"description":"HEARING AID ACCESSORIES TYPE D","code_information":[{"code":"55614025","type":"CDM"},{"code":"271","type":"RC"},{"code":"V5267","type":"HCPCS"}],"standard_charges":[{"gross_charge":500.0,"discounted_cash":450.0,"setting":"both","modifier_code":["GY"],"billing_class":"facility","additional_generic_notes":"The modified price is presented in the standard charge value. | Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"}]},{"description":"HEARING AID ACCESSORIES 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modified price is presented in the standard charge value. | Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"}]},{"description":"BINAURAL CIC DIAMOND","code_information":[{"code":"55615020","type":"CDM"},{"code":"471","type":"RC"},{"code":"V5258","type":"HCPCS"}],"standard_charges":[{"gross_charge":7200.0,"discounted_cash":6480.0,"setting":"both","modifier_code":["GY"],"billing_class":"facility","additional_generic_notes":"The modified price is presented in the standard charge value. | Modifier GY: Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit"}]},{"description":"BINAURAL ITC 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