Sheryl Hall, CRNA
Certified Registered Nurse Anesthetist · Houston, TX 77042 · NPI 1467481937 · 2 payer files
76%of Medicare
Cigna — Houston FlexCare pays Sheryl Hall, CRNA $73.13 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 $60.22 to $86.04; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston certified registered nurse anesthetists, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Houston FlexCare | $73.13median of 2 rows · $60.22–$86.04 | $96.33 | 76% | above 19% of 17 Houston certified registered nurse anesthetists on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $69.35median of 20 rows · $55.29–$81.59 | $96.33 | 72% | above 8% of 816 Houston certified registered nurse anesthetists on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Houston FlexCare | $109.73median of 2 rows · $92.87–$126.60 | $137.41 | 80% | above 19% of 17 Houston certified registered nurse anesthetists on this plan |
| Aetna — Texas (office visit and psychotherapy codes only) | $100.60median of 20 rows · $81.20–$118.37 | $137.41 | 73% | above 12% of 612 Houston certified registered nurse anesthetists on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston certified registered nurse anesthetists, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Houston FlexCare | $77.54median of 2 rows · $77.12–$77.96 | $82.68 | 94% | not typically billed by certified registered nurse anesthetists |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Houston FlexCare | $129.53median of 2 rows · $129.11–$129.94 | $138.62 | 93% | not typically billed by certified registered nurse anesthetists |
| 70553MRI brain, with and without contrast | Cigna — Houston FlexCare | $328.59 | $317.92 | 103% | not typically billed by certified registered nurse anesthetists |
| 72148MRI lumbar spine, without contrast | Cigna — Houston FlexCare | $194.83 | $192.38 | 101% | not typically billed by certified registered nurse anesthetists |
| 74177CT abdomen and pelvis, with contrast | Cigna — Houston FlexCare | $270.96 | $300.72 | 90% | not typically billed by certified registered nurse anesthetists |
| 77067Screening mammography, bilateral | Cigna — Houston FlexCare | $118.66 | $126.38 | 94% | not typically billed by certified registered nurse anesthetists |
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 Sheryl Hall, CRNA performs these services, and they are kept out of the benchmark above.