Sylvia VU, FNP-C
Family Nurse Practitioner · Houston, TX 77055 · NPI 1780465427 · 1 payer file
66%of Medicare
Cigna — Texas Connect (individual & family) pays Sylvia VU, FNP-C $64.03 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 $53.95 to $74.12; 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) | $64.03median of 2 rows · $53.95–$74.12 | $96.33 | 66% | above 33% of 62 Houston family nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Cigna — Texas Connect (individual & family) | $92.12median of 2 rows · $79.48–$104.76 | $137.41 | 67% | above 33% of 62 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) | $54.34median of 2 rows · $51.21–$57.46 | $82.68 | 66% | not typically billed by family nurse practitioners |
| 90838Psychotherapy, 60 minutes, add-on to an office visit | Cigna — Texas Connect (individual & family) | $90.64median of 2 rows · $85.67–$95.61 | $138.62 | 65% | not typically billed by family nurse practitioners |
| 70553MRI brain, with and without contrast | Cigna — Texas Connect (individual & family) | $246.88 | $317.92 | 78% | not typically billed by family nurse practitioners |
| 72148MRI lumbar spine, without contrast | Cigna — Texas Connect (individual & family) | $147.85 | $192.38 | 77% | not typically billed by family nurse practitioners |
| 74177CT abdomen and pelvis, with contrast | Cigna — Texas Connect (individual & family) | $237.93 | $300.72 | 79% | not typically billed by family nurse practitioners |
| 77067Screening mammography, bilateral | Cigna — Texas Connect (individual & family) | $94.55 | $126.38 | 75% | 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 Sylvia VU, FNP-C performs these services, and they are kept out of the benchmark above.