Marina Konopleva, M.D. PHD
Hematology & Oncology Physician · Houston, TX 77030 · NPI 1518063486 · 1 payer file
80%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Marina Konopleva, M.D. PHD $76.82 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 46 contract rows for this clinician and code, from $39.89 to $390.67; 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 | Aetna — Texas (office visit and psychotherapy codes only) | $76.82median of 46 rows · $39.89–$390.67 | $96.33 | 80% | above 20% of 169 Houston hematology & oncology physicians on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $110.90median of 46 rows · $54.00–$545.00 | $137.41 | 81% | above 20% 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 | Aetna — Texas (office visit and psychotherapy codes only) | $93.68median of 20 rows · $70.26–$290.42 | $82.68 | 113% | not typically billed by hematology & oncology physicians |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $158.41median of 20 rows · $118.81–$478.99 | $138.62 | 114% | 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 Marina Konopleva, M.D. PHD performs these services, and they are kept out of the benchmark above.