Ronald Lavoie, D.C.
Chiropractor · Houston, TX 77068 · NPI 1275604084
29%of Medicare
BCBSTX pays Ronald Lavoie, D.C. $28.20 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 chiropractors |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $28.20 | $96.33 | 29% | above 0% of 212 Houston chiropractors |
| 99214Office visit, established patient, moderate complexity | $59.99 | $137.41 | 44% | above 0% of 212 Houston chiropractors |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $252.85 | $317.92 | 80% | not typically billed by chiropractors |
| 72148MRI lumbar spine, without contrast | $151.55 | $192.38 | 79% | not typically billed by chiropractors |
| 77067Screening mammography, bilateral | $28.12 | $126.38 | 22% | not typically billed by chiropractors |
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 Ronald Lavoie, D.C. performs these services, and they are kept out of the benchmark above.