BO Chen
Nuclear Radiology Physician · Houston, TX 77030 · NPI 1053730663
43%of Medicare
BCBSTX pays BO Chen $136.24 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 nuclear radiology physicians |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $136.24 | $317.92 | 43% | above 38% of 17,053 all Houston clinicians |
| 72148MRI lumbar spine, without contrast | $87.88 | $192.38 | 46% | above 5% of 17,608 all Houston clinicians |
| 74177CT abdomen and pelvis, with contrast | $113.29 | $300.72 | 38% | above 63% of 18,157 all Houston clinicians |
| 77067Screening mammography, bilateral | $161.89 | $126.38 | 128% | above 75% of 18,167 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $134.22 | $96.33 | 139% | not typically billed by nuclear radiology physicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | not typically billed by nuclear radiology 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 BO Chen performs these services, and they are kept out of the benchmark above.