Sonali Hanson, M.D.
Specialist · Houston, TX 77074 · NPI 1518932755
54%of Medicare
BCBSTX pays Sonali Hanson, M.D. $51.98 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
| Service | BCBSTX | Medicare | % of Medicare | Among Houston specialists |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $51.98 | $96.33 | 54% | above 10% of 71 Houston specialists |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 9% of 71 Houston specialists |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by specialists |
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 Sonali Hanson, M.D. performs these services, and they are kept out of the benchmark above.