PayerParity

Gerald Heisler, M.D.

Family Medicine Physician · Houston, TX 77028 · NPI 1245310168 · 1 payer file

73%of Medicare

Aetna — Texas (office visit and psychotherapy codes only) pays Gerald Heisler, M.D. $100.09 for a 99214 — Office visit, established patient, moderate complexity. Medicare pays $137.41 for the same service in this locality. Commercial insurance is widely assumed to pay above Medicare. The file lists 20 contract rows for this clinician and code, from $78.98 to $117.76; the median is shown.

Negotiated rates vs Medicare

ServicePayer · planNegotiatedMedicare% of MedicareAmong Houston family medicine physicians, same plan
99214Office visit, established patient, moderate complexityAetna — Texas (office visit and psychotherapy codes only)$100.09median of 20 rows · $78.98–$117.76$137.4173%

above 13% of 632 Houston family medicine physicians on this plan

Sources. Aetna — Texas (office visit and psychotherapy codes only) (August 2026 extract). Each payer’s machine-readable file, joined to the national provider registry by NPI. Rates are the negotiated professional amounts — not billed charges, and not what a member owes after cost sharing. Where a file carries several contract rows for one clinician and code, the median is shown with the range and row count beneath it.

Medicare. Non-facility allowed amount, HOUSTON, Texas, Locality 18, CY2026 non-QP conversion factor, computed from RVUs and the locality’s geographic indices — not looked up from a table.

Position. Percentile of this rate among Houston clinicians in the same specialty holding a rate for the same code on the same plan; falls back to all Houston clinicians on that plan where the specialty cohort is under ten. Payers are never pooled.

Built 2026-09-03 · PayerParity