PayerParity

Susan Denfield, MD

Pediatric Cardiology Physician · Houston, TX 77030 · NPI 1932289378 · 1 payer file

126%of Medicare

Aetna — Texas (office visit and psychotherapy codes only) pays Susan Denfield, MD $121.11 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 56 contract rows for this clinician and code, from $93.81 to $142.79; the median is shown.

Negotiated rates vs Medicare

ServicePayer · planNegotiatedMedicare% of MedicareAmong Houston pediatric cardiology physicians, same plan
99213Office visit, established patient, low complexityAetna — Texas (office visit and psychotherapy codes only)$121.11median of 56 rows · $93.81–$142.79$96.33126%

above 43% of 84 Houston pediatric cardiology physicians on this plan

99214Office visit, established patient, moderate complexityAetna — Texas (office visit and psychotherapy codes only)$175.62median of 56 rows · $138.23–$207.14$137.41128%

above 44% of 85 Houston pediatric cardiology 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