Shirley Adeniji, DC
Chiropractor · Houston, TX 77074 · NPI 1568281673 · 1 payer file
53%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Shirley Adeniji, DC $51.25 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 24 contract rows for this clinician and code, from $37.70 to $69.63; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston chiropractors, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Aetna — Texas (office visit and psychotherapy codes only) | $51.25median of 24 rows · $37.70–$69.63 | $96.33 | 53% | above 1% of 134 Houston chiropractors on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $77.06median of 24 rows · $57.97–$102.43 | $137.41 | 56% | above 2% of 115 Houston chiropractors on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston chiropractors, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $49.06median of 24 rows · $40.74–$61.12 | $82.68 | 59% | not typically billed by chiropractors |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Aetna — Texas (office visit and psychotherapy codes only) | $82.53median of 24 rows · $68.64–$102.66 | $138.62 | 60% | not typically billed by chiropractors |
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 Shirley Adeniji, DC performs these services, and they are kept out of the benchmark above.