PayerParity

Ramy Ghaly, M.D.

Internal Medicine Physician · Houston, TX 77030 · NPI 1780321075 · 1 payer file

61%of Medicare

Aetna — Texas (office visit and psychotherapy codes only) pays Ramy Ghaly, M.D. $58.54 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 $43.13 to $79.43; the median is shown.

Negotiated rates vs Medicare

ServicePayer · planNegotiatedMedicare% of MedicareAmong Houston internal medicine physicians, same plan
99213Office visit, established patient, low complexityAetna — Texas (office visit and psychotherapy codes only)$58.54median of 24 rows · $43.13–$79.43$96.3361%

above 2% of 898 Houston internal medicine physicians on this plan

99214Office visit, established patient, moderate complexityAetna — Texas (office visit and psychotherapy codes only)$84.31median of 24 rows · $63.50–$111.94$137.4161%

above 1% of 899 Houston internal medicine physicians on this plan

Sources. Aetna — Texas (office visit and psychotherapy codes only) (August 2026 extract). Each payer’s machine-readable file, joined to the national provider registry by NPI. Rates are the negotiated professional amounts — not billed charges, and not what a member owes after cost sharing. Where a file carries several contract rows for one clinician and code, the median is shown with the range and row count beneath it.

Medicare. Non-facility allowed amount, HOUSTON, Texas, Locality 18, CY2026 non-QP conversion factor, computed from RVUs and the locality’s geographic indices — not looked up from a table.

Position. Percentile of this rate among Houston clinicians in the same specialty holding a rate for the same code on the same plan; falls back to all Houston clinicians on that plan where the specialty cohort is under ten. Payers are never pooled.

Built 2026-09-03 · PayerParity