Mark Nichols, MD
Otology & Neurotology Physician · Houston, TX 77024 · NPI 1215910732
54%of Medicare
BCBSTX pays Mark Nichols, MD $51.98 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.
Negotiated rates vs Medicare
| Service | BCBSTX | Medicare | % of Medicare | Among Houston otology & neurotology physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $51.98 | $96.33 | 54% | above 39% of 24,819 all Houston clinicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 26% of 24,759 all Houston clinicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $88.84 | $317.92 | 28% | not typically billed by otology & neurotology physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by otology & neurotology 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 Mark Nichols, MD performs these services, and they are kept out of the benchmark above.