Megan Swonke, MD
Facial Plastic Surgery Physician · Houston, TX 77018 · NPI 1336704121 · 1 payer file
113%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Megan Swonke, MD $108.99 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 8 contract rows for this clinician and code, from $91.51 to $126.47; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston facial plastic surgery physicians, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $108.99median of 8 rows · $91.51–$126.47 | $96.33 | 113% | above 75% of 21,862 all Houston clinicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $156.59median of 8 rows · $134.78–$178.40 | $137.41 | 114% | above 76% of 21,418 all Houston clinicians on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston facial plastic surgery physicians, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $94.72median of 8 rows · $89.26–$100.17 | $82.68 | 115% | not typically billed by facial plastic surgery 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 Megan Swonke, MD performs these services, and they are kept out of the benchmark above.