David Vining, M.D.
Body Imaging Physician · Houston, TX 77030 · NPI 1043238819
49%of Medicare
BCBSTX pays David Vining, M.D. $157.20 for a 70553 — MRI brain, with and without contrast. Medicare pays $317.92 for the same service in this locality. Commercial insurance is widely assumed to pay above Medicare.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston body imaging physicians |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $157.20 | $317.92 | 49% | above 46% of 17,053 all Houston clinicians |
| 72148MRI lumbar spine, without contrast | $101.41 | $192.38 | 53% | above 12% of 17,608 all Houston clinicians |
| 74177CT abdomen and pelvis, with contrast | $358.93 | $300.72 | 119% | above 88% of 18,157 all Houston clinicians |
| 77067Screening mammography, bilateral | $59.85 | $126.38 | 47% | above 69% of 18,167 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $55.78 | $96.33 | 58% | not typically billed by body imaging physicians |
| 99214Office visit, established patient, moderate complexity | $85.98 | $137.41 | 63% | not typically billed by body imaging physicians |
A payer’s file carries a rate for every code in the contract’s fee class, whether or not the clinician will ever bill it. These rows are real, and they are how the fee class shows through — but they are not evidence that David Vining, M.D. performs these services, and they are kept out of the benchmark above.