{"reporting_entity_name":"Blue Shield of California","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-03-13","version":"2.0.0","provider_references":[{"provider_group_id":1042,"network_name":["H1"],"provider_groups":[{"npi":[1124172358],"tin":{"type":"ein","value":"95-4365761","business_name":"ASSOCIATED HISPANIC PHYS IPA"}}]},{"provider_group_id":1043,"network_name":["H1"],"provider_groups":[{"npi":[1275655250],"tin":{"type":"ein","value":"95-3846788","business_name":"PREMIER PHYSICIANS NETWORK"}}]},{"provider_group_id":1044,"network_name":["H1"],"provider_groups":[{"npi":[1619187978],"tin":{"type":"ein","value":"95-4535099","business_name":"ANGELES IPA"}}]},{"provider_group_id":1045,"network_name":["H1"],"provider_groups":[{"npi":[1790730786],"tin":{"type":"ein","value":"33-0204654","business_name":"CHINO MEDICAL GROUP INC"}}]},{"provider_group_id":1046,"network_name":["H1"],"provider_groups":[{"npi":[1629291810],"tin":{"type":"ein","value":"95-4469504","business_name":"SEOUL MEDICAL GROUP INC"}}]},{"provider_group_id":1047,"network_name":["H1"],"provider_groups":[{"npi":[1518114677],"tin":{"type":"ein","value":"33-0573709","business_name":"PROMISECARE MEDICAL GRP INC - HEMET COMMUNITY MEDICAL G"}}]},{"provider_group_id":1048,"network_name":["H1"],"provider_groups":[{"npi":[1093844656],"tin":{"type":"ein","value":"95-4457453","business_name":"BELLA VISTA MEDICAL GROUP IPA"}}]},{"provider_group_id":1049,"network_name":["H1"],"provider_groups":[{"npi":[1164552378],"tin":{"type":"ein","value":"95-4730100","business_name":"CENTINELA VALLEY IPA"}}]},{"provider_group_id":1050,"network_name":["H1"],"provider_groups":[{"npi":[1225172984],"tin":{"type":"ein","value":"95-4729595","business_name":"ST VINCENT IPA MED CORP"}}]},{"provider_group_id":1051,"network_name":["H1"],"provider_groups":[{"npi":[1477677961],"tin":{"type":"ein","value":"95-4582615","business_name":"FAMILY CARE SPECIALISTS IPA"}}]},{"provider_group_id":1052,"network_name":["H1"],"provider_groups":[{"npi":[1376583344],"tin":{"type":"ein","value":"33-0184827","business_name":"PREMIER HEALTH PLAN SERVICES INC"}}]},{"provider_group_id":1053,"network_name":["H1"],"provider_groups":[{"npi":[1457548604],"tin":{"type":"ein","value":"95-4449869","business_name":"OMNICARE MEDICAL GROUP"}}]},{"provider_group_id":1054,"network_name":["H1"],"provider_groups":[{"npi":[1275655250],"tin":{"type":"ein","value":"95-3846788","business_name":"PREMIER PHYSICIANS NETWORK"}}]},{"provider_group_id":1055,"network_name":["H1"],"provider_groups":[{"npi":[1225080864],"tin":{"type":"ein","value":"95-4337143","business_name":"HISPANIC PHYSICIANS IPA"}}]},{"provider_group_id":1056,"network_name":["H1"],"provider_groups":[{"npi":[1821018433],"tin":{"type":"ein","value":"33-0455953","business_name":"CORWIN MEDICAL GROUP IPA INC"}},{"npi":[1801929757],"tin":{"type":"ein","value":"95-4298276","business_name":"HEALTHCARE L A INC"}}]},{"provider_group_id":1057,"network_name":["H1"],"provider_groups":[{"npi":[1619190881],"tin":{"type":"ein","value":"33-0608012","business_name":"FAMILY HEALTH ALLIANCE"}}]},{"provider_group_id":1058,"network_name":["H1"],"provider_groups":[{"npi":[1821018433],"tin":{"type":"ein","value":"33-0455953","business_name":"CORWIN MEDICAL GROUP IPA INC"}}]},{"provider_group_id":1059,"network_name":["H1"],"provider_groups":[{"npi":[1326171265],"tin":{"type":"ein","value":"95-4439760","business_name":"GLOBAL CARE MEDICAL GRP INC"}}]},{"provider_group_id":1060,"network_name":["H1"],"provider_groups":[{"npi":[1770537466],"tin":{"type":"ein","value":"33-0185031","business_name":"PROVIDENCE MEDICAL GROUP FOUNDATION"}}]},{"provider_group_id":1061,"network_name":["H1"],"provider_groups":[{"npi":[1457548091],"tin":{"type":"ein","value":"95-4247138","business_name":"ACCESS MEDICAL GROUP INC"}}]},{"provider_group_id":1062,"network_name":["H1"],"provider_groups":[{"npi":[1124027529],"tin":{"type":"ein","value":"95-4634826","business_name":"GREATER COVINA MEDICAL GROUP INC"}}]},{"provider_group_id":1063,"network_name":["H1"],"provider_groups":[{"npi":[1427093236],"tin":{"type":"ein","value":"95-4786125","business_name":"SERRA COMMUNITY MEDICAL CLINIC INC"}}]},{"provider_group_id":1064,"network_name":["H1"],"provider_groups":[{"npi":[1114212685],"tin":{"type":"ein","value":"95-4367156","business_name":"CITRUS VALLEY PHYS GRP"}}]},{"provider_group_id":1065,"network_name":["H1"],"provider_groups":[{"npi":[1477760940],"tin":{"type":"ein","value":"95-4385217","business_name":"ALLIED PACIFIC OF CALIF IPA"}}]},{"provider_group_id":1066,"network_name":["H1"],"provider_groups":[{"npi":[1528279080],"tin":{"type":"ein","value":"33-0845270","business_name":"GREATER TRI CITIES IPA"}}]},{"provider_group_id":1067,"network_name":["H1"],"provider_groups":[{"npi":[1609925957,1871607762],"tin":{"type":"ein","value":"33-0185031","business_name":"PROVIDENCE MEDICAL GROUP FOUNDATION"}}]},{"provider_group_id":1068,"network_name":["H1"],"provider_groups":[{"npi":[1457548091],"tin":{"type":"ein","value":"95-4247138","business_name":"ACCESS MEDICAL GROUP INC"}}]},{"provider_group_id":1069,"network_name":["H1"],"provider_groups":[{"npi":[1922127422],"tin":{"type":"ein","value":"33-0457134","business_name":"SAN DIEGO PHYS MED GRP"}}]},{"provider_group_id":1070,"network_name":["H1"],"provider_groups":[{"npi":[1689797342],"tin":{"type":"ein","value":"33-0724304","business_name":"PHYSICIAN CHOICE MED GRP OF SAN LUIS OBISPO"}}]},{"provider_group_id":1071,"network_name":["H1"],"provider_groups":[{"npi":[1942293279],"tin":{"type":"ein","value":"95-4714494","business_name":"AXMINSTER MEDICAL GROUP INC"}}]},{"provider_group_id":1072,"network_name":["H1"],"provider_groups":[{"npi":[1942799523],"tin":{"type":"ein","value":"33-0676831","business_name":"HOAG CLINIC"}}]},{"provider_group_id":1073,"network_name":["H1"],"provider_groups":[{"npi":[1346252533],"tin":{"type":"ein","value":"33-0073515","business_name":"TORRANCE HEALTH ASSOCIATES"}}]},{"provider_group_id":1074,"network_name":["H1"],"provider_groups":[{"npi":[1710031588],"tin":{"type":"ein","value":"95-4322584","business_name":"PROVIDENCE FACEY MEDICAL FOUNDATION"}}]},{"provider_group_id":1075,"network_name":["H1"],"provider_groups":[{"npi":[1316023013],"tin":{"type":"ein","value":"77-0243333","business_name":"ALLCARE IPA"}}]},{"provider_group_id":1076,"network_name":["H1"],"provider_groups":[{"npi":[1902903388],"tin":{"type":"ein","value":"95-4142044","business_name":"POMONA VALLEY MED GRP INC DBA PRO MED HLTH NWK"}}]},{"provider_group_id":1077,"network_name":["H1"],"provider_groups":[{"npi":[1386721934],"tin":{"type":"ein","value":"33-0865659","business_name":"SEAVIEW IPA PROFESSIONAL CORPORATION"}}]},{"provider_group_id":1078,"network_name":["H1"],"provider_groups":[{"npi":[1720446255],"tin":{"type":"ein","value":"47-5605950","business_name":"ALL AMERICAN MEDICAL GROUP"}}]},{"provider_group_id":1079,"network_name":["H1"],"provider_groups":[{"npi":[1134252802,1881636108],"tin":{"type":"ein","value":"33-0782099","business_name":"SCRIPPS CLINIC MEDICAL GRP"}}]},{"provider_group_id":1080,"network_name":["H1"],"provider_groups":[{"npi":[1588829006],"tin":{"type":"ein","value":"95-3942828","business_name":"PIH HEALTH PHYSICIANS"}}]},{"provider_group_id":1081,"network_name":["H1"],"provider_groups":[{"npi":[1730180415],"tin":{"type":"ein","value":"33-0587303","business_name":"RIVERSIDE MEDICAL CLINIC"}}]},{"provider_group_id":1082,"network_name":["H1"],"provider_groups":[{"npi":[1891175444],"tin":{"type":"ein","value":"94-2722082","business_name":"PHYSICIANS MEDICAL GROUP SAN JOSE"}}]},{"provider_group_id":1083,"network_name":["H1"],"provider_groups":[{"npi":[1275735011,1588748073,1831426642],"tin":{"type":"ein","value":"95-4582920","business_name":"HERITAGE PROVIDER NETWORK INC"}}]},{"provider_group_id":1084,"network_name":["H1"],"provider_groups":[{"npi":[1659312593],"tin":{"type":"ein","value":"46-2385459","business_name":"DAVITA HEALTHCARE PARTNERS PLAN INC"}}]},{"provider_group_id":1085,"network_name":["H1"],"provider_groups":[{"npi":[1184782724],"tin":{"type":"ein","value":"33-0527335","business_name":"PRIMARY CARE ASSOCIATES MEDICAL GROUP IN"}}]},{"provider_group_id":1086,"network_name":["H1"],"provider_groups":[{"npi":[1275657827],"tin":{"type":"ein","value":"47-3366764","business_name":"GEMCARE MEDICAL GROUP INC"}}]},{"provider_group_id":1087,"network_name":["H1"],"provider_groups":[{"npi":[1902930381],"tin":{"type":"ein","value":"94-3008941","business_name":"SANTA CLARA CNTY IPA"}}]},{"provider_group_id":1088,"network_name":["H1"],"provider_groups":[{"npi":[1649503319],"tin":{"type":"ein","value":"27-2767291","business_name":"CHAFFEY MEDICAL GROUP"}}]},{"provider_group_id":1089,"network_name":["H1"],"provider_groups":[{"npi":[1912982216],"tin":{"type":"ein","value":"95-1643359","business_name":"ST JOSEPH HOSPITAL"}}]},{"provider_group_id":1090,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":1091,"network_name":["H1"],"provider_groups":[{"npi":[1417052739],"tin":{"type":"ein","value":"94-2944896","business_name":"HILL PHYSICIANS MED GRP INC"}}]},{"provider_group_id":1092,"network_name":["H1"],"provider_groups":[{"npi":[1841277704],"tin":{"type":"ein","value":"95-1684089","business_name":"SCRIPPS HEALTH"}}]},{"provider_group_id":1093,"network_name":["H1"],"provider_groups":[{"npi":[1841407665],"tin":{"type":"ein","value":"68-0360801","business_name":"JOHN MUIR PHYSICIAN NETWORK"}}]},{"provider_group_id":1094,"network_name":["H1"],"provider_groups":[{"npi":[1477074474],"tin":{"type":"ein","value":"35-2567959","business_name":"DIGNITY HEALTH MEDICAL NETWORK - SANTA CRUZ"}}]},{"provider_group_id":1095,"network_name":["H1"],"provider_groups":[{"npi":[1669617197],"tin":{"type":"ein","value":"95-1691313","business_name":"CHILDRENS HOSPITAL SAN DIEGO"}}]},{"provider_group_id":1096,"network_name":["H1"],"provider_groups":[{"npi":[1144497678],"tin":{"type":"ein","value":"57-1205856","business_name":"DIGNITY HEALTH MEDICAL FOUNDATION"}}]}],"in_network":[{"negotiation_arrangement":"capitation","name":"PMPM","description":"Per Member Per Month","billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","severity_of_illness":"","negotiated_rates":[{"provider_references":[1042],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":61.78,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1043],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":78.69,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1044],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":82.39,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1045],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":82.94,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1046],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":83.29,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1047],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":85.28,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1048],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":86.7,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1049],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":87.41,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1050],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":87.94,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1051],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":88.56,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1052],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":88.63,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1053],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":88.87,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1054],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":89.36,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1055],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":92.16,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1056],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":93.01,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1057],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":93.08,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1058],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":93.99,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1059],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":95.41,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1060],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":96.42,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1061],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":105.92,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1062],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":106.83,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1063],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":109.78,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1064],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":110.01,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1065],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":114.15,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1066],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":122.84,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1067],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":125.59,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1068],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":129.91,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1069],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":134.97,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1070],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":137.52,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1071],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":142.74,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1072],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":145.51,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1073],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":146.4,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1074],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":154.02,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1075],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":155.49,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1076],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":161.45,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1077],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":161.59,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1078],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":163.04,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1079],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":165,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1080],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":167.09,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1081],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":168.85,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1082],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":168.93,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1083],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":170.92,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1084],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":171.75,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1085],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":172.22,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1086],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":173.33,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1087],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":174.19,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1088],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":179.04,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1089],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":186.77,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"institutional"}]},{"provider_references":[1090],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":208.5,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1091],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":209.58,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1092],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":211.23,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"institutional"}]},{"provider_references":[1093],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":216.26,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1094],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":218.05,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1095],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":233.2,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]},{"provider_references":[1096],"negotiated_prices":[{"setting":"Both","negotiated_type":"negotiated","negotiated_rate":263.39,"expiration_date":"9999-12-31","service_code":["CSTM-00"],"billing_class":"professional"}]}],"covered_services":[{"billing_code_type":"CSTM-ALL","billing_code_type_version":"2026","billing_code":"CSTM-00","description":"Per Member Per Month"}]}]}