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$start = {
           'lineitem' => {
...
                          'market_x_branch' => 1
                        }
};

$end = [
          [
...
            'insurer'
          ]
        ];

foreach my $x (keys %$start)
{
...
    push @$end, \@values;
    delete $start->{$_} for @values;
}

$start = {
          'lineitem' => {
...
        'lineitem',
     ],
];