Sean Morris
Albany-Schenectady-Troy, NY
Bcbsnm is the worst-paying contract we can score for Sean Morris — 93.8% of local peers, paid by the same payer for the same codes in the same metro, are paid more. That is the payer's pricing decision, not a reflection on this provider.
Position by payer
Your median contracted rate vs the local peer median, per payer, for every payer we can score in Albany-Schenectady-Troy, NY. Where a Blue Cross entity's label carries a state, that state names the file we found the rate in, not this practice's location — Blue Cross plans file separately per state and do not share rates, even for the same provider.
| Payer | Codes | Your median | Local peer median | Gap | RateScore |
|---|---|---|---|---|---|
| Bcbsnm | 1 | $106.43 | $248.49 | −$142.06 | 334 |
| Empire BlueCross BlueShield (NY file) | 3 | $70.35 | $70.35 | $0.00 | 552 |
| Aetna | 3 | $17.42 | $20.35 | −$2.93 | 638 |
Documented reimbursement opportunity
The largest per-encounter gaps to the local P90 target, code by code. Modeled from published rates, not guaranteed — per encounter, not annualized.
| Payer | CPT | Your rate | Local median | Local P90 | Per-encounter gap | Peers |
|---|---|---|---|---|---|---|
| Bcbsnm | 10061 | $106.43 | $248.49 | $455.31 | $348.88 | 56 |
| Empire BlueCross BlueShield (NY file) | 99204 | $124.74 | $250.36 | $273.19 | $148.45 | 79 |
| Empire BlueCross BlueShield (NY file) | 99213 | $70.35 | $70.35 | $137.77 | $67.42 | 397 |
| Aetna | 96372 | $17.42 | $20.35 | $36.97 | $19.55 | 23 |
| Empire BlueCross BlueShield (NY file) | 71046 | $51.06 | $34.04 | $65.61 | $14.55 | 47 |
| Aetna | 71046 | $28.78 | $27.01 | $42.24 | $13.46 | 35 |
| Aetna | 81002 | $4.00 | $3.52 | $5.22 | $1.22 | 36 |
What insurers pay nationally for these codes: 10061 · 99204 · 99213
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