Nicole Valencia, CRNA
Certified Registered Nurse Anesthetist · Houston, TX 77058 · NPI 1548664980 · 1 payer file
81%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Nicole Valencia, CRNA $77.83 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 72 contract rows for this clinician and code, from $44.00 to $187.09; 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 | Aetna — Texas (office visit and psychotherapy codes only) | $77.83median of 72 rows · $44.00–$187.09 | $96.33 | 81% | above 40% of 816 Houston certified registered nurse anesthetists on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $113.86median of 72 rows · $64.76–$263.61 | $137.41 | 83% | above 55% 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 | Aetna — Texas (office visit and psychotherapy codes only) | $63.84median of 32 rows · $48.71–$146.53 | $82.68 | 77% | 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 Nicole Valencia, CRNA performs these services, and they are kept out of the benchmark above.