Rachel High, D.O.
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician · Houston, TX 77030 · NPI 1245677582
60%of Medicare
BCBSTX pays Rachel High, D.O. $57.73 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 urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $57.73 | $96.33 | 60% | above 32% of 20 Houston urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) physicians |
| 99214Office visit, established patient, moderate complexity | $88.98 | $137.41 | 65% | above 42% of 20 Houston urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) physicians |
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 urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) physicians |
| 72148MRI lumbar spine, without contrast | $159.58 | $192.38 | 83% | not typically billed by urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) physicians |
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | not typically billed by urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by urogynecology and reconstructive pelvic surgery (obstetrics & gynecology) 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 Rachel High, D.O. performs these services, and they are kept out of the benchmark above.