PayerParity

Stephen Dolgner, M.D.

Adult Congenital Heart Disease Physician · Houston, TX 77030 · NPI 1407099138

64%of Medicare

BCBSTX pays Stephen Dolgner, M.D. $61.45 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

ServiceBCBSTXMedicare% of MedicareAmong Houston adult congenital heart disease physicians
99213Office visit, established patient, low complexity$61.45$96.3364%

above 58% of 24,819 all Houston clinicians

99214Office visit, established patient, moderate complexity$140.45$137.41102%

above 85% of 24,759 all Houston clinicians

Source. Blue Cross Blue Shield of Texas machine-readable file, June 2026, 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.

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; falls back to all Houston clinicians where the specialty cohort is under ten.

Built 2026-09-03 · PayerParity