Anthony Costales, M.D.
Gynecologic Oncology Physician · Houston, TX 77054 · NPI 1578828703
64%of Medicare
BCBSTX pays Anthony Costales, M.D. $61.45 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 gynecologic oncology physicians |
|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | $61.45 | $96.33 | 64% | above 27% of 45 Houston gynecologic oncology physicians |
| 99214Office visit, established patient, moderate complexity | $80.13 | $137.41 | 58% | above 2% of 45 Houston gynecologic oncology physicians |
Also contracted — outside this specialty’s usual billing
| Service | BCBSTX | Medicare | % | |
|---|---|---|---|---|
| 70553MRI brain, with and without contrast | $88.84 | $317.92 | 28% | not typically billed by gynecologic oncology physicians |
| 74177CT abdomen and pelvis, with contrast | $70.74 | $300.72 | 24% | not typically billed by gynecologic oncology physicians |
| 77067Screening mammography, bilateral | $29.61 | $126.38 | 23% | not typically billed by gynecologic 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 Anthony Costales, M.D. performs these services, and they are kept out of the benchmark above.