Glenda Bradley, APRN-BC
Family Nurse Practitioner · Houston, TX 77090 · NPI 1598774093 · 3 payer files
56%of Medicare
Cigna — Texas Connect (individual & family) pays Glenda Bradley, APRN-BC $53.79 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 2 contract rows for this clinician and code, from $53.79 to $53.79; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston family nurse practitioners, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $53.79median of 2 rows · $53.79–$53.79 | $96.33 | 56% | above 8% of 62 Houston family nurse practitioners on this plan |
| UnitedHealthcare — Optum Behavioral Health | $77.20 | $96.33 | 80% | above 7% of 15 Houston family nurse practitioners on this plan | |
| Aetna — Texas (office visit and psychotherapy codes only) | $69.36median of 20 rows · $55.30–$81.60 | $96.33 | 72% | above 55% of 1,439 Houston family nurse practitioners on this plan | |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $84.39median of 2 rows · $84.39–$84.39 | $137.41 | 61% | above 8% of 62 Houston family nurse practitioners on this plan |
| UnitedHealthcare — Optum Behavioral Health | $109.17 | $137.41 | 79% | above 7% of 15 Houston family nurse practitioners on this plan | |
| Aetna — Texas (office visit and psychotherapy codes only) | $100.61median of 20 rows · $81.21–$118.37 | $137.41 | 73% | above 54% of 1,443 Houston family nurse practitioners on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston family nurse practitioners, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $38.00median of 2 rows · $38.00–$38.00 | $82.68 | 46% | not typically billed by family nurse practitioners |
| UnitedHealthcare — Optum Behavioral Health | $64.63 | $82.68 | 78% | not typically billed by family nurse practitioners | |
| Aetna — Texas (office visit and psychotherapy codes only) | $66.56median of 12 rows · $58.73–$78.30 | $82.68 | 81% | not typically billed by family nurse practitioners | |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $101.00median of 2 rows · $101.00–$101.00 | $138.62 | 73% | not typically billed by family nurse practitioners |
| UnitedHealthcare — Optum Behavioral Health | $99.08 | $138.62 | 71% | not typically billed by family nurse practitioners | |
| Aetna — Texas (office visit and psychotherapy codes only) | $115.61median of 12 rows · $102.01–$136.02 | $138.62 | 83% | not typically billed by family nurse practitioners |
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 Glenda Bradley, APRN-BC performs these services, and they are kept out of the benchmark above.