Audra Cosart-banerji, P.A.
Physician Assistant · Houston, TX 77030 · NPI 1598905051 · 1 payer file
65%of Medicare
Cigna — Texas Connect (individual & family) pays Audra Cosart-banerji, P.A. $62.67 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 $52.35 to $73.00; the median is shown.
Negotiated rates vs Medicare
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physician assistants, same plan |
|---|---|---|---|---|---|
| 99213Office visit, established patient, low complexity | Cigna — Texas Connect (individual & family) | $62.67median of 2 rows · $52.35–$73.00 | $96.33 | 65% | above 28% of 58 Houston physician assistants on this plan |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $90.09median of 2 rows · $77.22–$102.96 | $137.41 | 66% | above 30% of 58 Houston physician assistants on this plan |
Also contracted — outside this specialty’s usual billing
| Service | Payer · plan | Negotiated | Medicare | % of Medicare | Among Houston physician assistants, same plan |
|---|---|---|---|---|---|
| 90833Psychotherapy, 30 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $58.05median of 2 rows · $54.63–$61.46 | $82.68 | 70% | not typically billed by physician assistants |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $97.34median of 2 rows · $91.64–$103.03 | $138.62 | 70% | not typically billed by physician assistants |
| 70553MRI brain, with and without contrast | Cigna — Texas Connect (individual & family) | $279.50 | $317.92 | 88% | not typically billed by physician assistants |
| 72148MRI lumbar spine, without contrast | Cigna — Texas Connect (individual & family) | $167.91 | $192.38 | 87% | not typically billed by physician assistants |
| 74177CT abdomen and pelvis, with contrast | Cigna — Texas Connect (individual & family) | $265.92 | $300.72 | 88% | not typically billed by physician assistants |
| 77067Screening mammography, bilateral | Cigna — Texas Connect (individual & family) | $109.31 | $126.38 | 86% | not typically billed by physician assistants |
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 Audra Cosart-banerji, P.A. performs these services, and they are kept out of the benchmark above.