Concepcion Diaz-arrastia, M.D.
Gynecologic Oncology Physician · Houston, TX 77004 · NPI 1104986553 · 1 payer file
70%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Concepcion Diaz-arrastia, M.D. $67.91 for a 99213 — Office visit, established patient, low complexity. Medicare pays $96.33 for the same service in this locality. Commercial insurance is widely assumed to pay above Medicare. The file lists 88 contract rows for this clinician and code, from $39.89 to $91.58; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston gynecologic oncology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $67.91median of 88 rows · $39.89–$91.58 | $96.33 | 70% | above 0% of 45 Houston gynecologic oncology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $97.85median of 98 rows · $54.00–$130.47 | $137.41 | 71% | above 0% of 45 Houston gynecologic oncology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston gynecologic oncology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $71.02median of 48 rows · $53.84–$93.68 | $82.68 | 86% | not typically billed by gynecologic oncology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $119.81median of 48 rows · $90.59–$158.42 | $138.62 | 86% | not typically billed by gynecologic oncology 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 Concepcion Diaz-arrastia, M.D. performs these services, and they are kept out of the benchmark above.