Lawrence Foote, M.D.
Hematology & Oncology Physician · Houston, TX 77030 · NPI 1295777456 · 2 payer files
104%of Medicare
Cigna — Texas Connect (individual & family) pays Lawrence Foote, M.D. $100.60 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 2 contract rows for this clinician and code, from $85.44 to $115.77; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hematology & oncology physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $100.60median of 2 rows · $85.44–$115.77 | $96.33 | 104% | above 0% of 14 Houston hematology & oncology physicians on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $77.28median of 8 rows · $64.56–$90.01 | $96.33 | 80% | above 21% of 169 Houston hematology & oncology physicians on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $145.38median of 2 rows · $126.32–$164.45 | $137.41 | 106% | above 0% of 14 Houston hematology & oncology physicians on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $116.38median of 8 rows · $99.28–$133.47 | $137.41 | 85% | above 22% of 170 Houston hematology & oncology physicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston hematology & oncology physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $92.43median of 2 rows · $87.30–$97.56 | $82.68 | 112% | not typically billed by hematology & oncology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $154.83median of 2 rows · $146.44–$163.23 | $138.62 | 112% | not typically billed by hematology & oncology physicians |
| 70553MRI brain, with and without contrast | Cigna — Texas Connect (individual & family) | $487.39 | $317.92 | 153% | not typically billed by hematology & oncology physicians |
| 72148MRI lumbar spine, without contrast | Cigna — Texas Connect (individual & family) | $290.76 | $192.38 | 151% | not typically billed by hematology & oncology physicians |
| 74177CT abdomen and pelvis, with contrast | Cigna — Texas Connect (individual & family) | $455.47 | $300.72 | 151% | not typically billed by hematology & oncology physicians |
| 77067Screening mammography, bilateral | Cigna — Texas Connect (individual & family) | $180.37 | $126.38 | 143% | not typically billed by hematology & 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 Lawrence Foote, M.D. performs these services, and they are kept out of the benchmark above.