Crystal Ugarte, FNP-C
Family Nurse Practitioner · Houston, TX 77009 · NPI 1932599784 · 1 payer file
65%of Medicare
Aetna — Texas (office visit and psychotherapy codes only) pays Crystal Ugarte, FNP-C $62.42 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 20 contract rows for this clinician and code, from $49.76 to $73.43; 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 | Aetna — Texas (office visit and psychotherapy codes only) | $62.42median of 20 rows · $49.76–$73.43 | $96.33 | 65% | above 20% of 1,439 Houston family nurse practitioners on this plan |
| 99214Office visit, established patient, moderate complexity | Aetna — Texas (office visit and psychotherapy codes only) | $90.54median of 20 rows · $73.08–$106.53 | $137.41 | 66% | above 19% 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 | Aetna — Texas (office visit and psychotherapy codes only) | $59.90median of 12 rows · $52.85–$70.46 | $82.68 | 72% | 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 Crystal Ugarte, FNP-C performs these services, and they are kept out of the benchmark above.