RateScore · NPI 1164413449

John Charles Wain

Boston-Cambridge-Newton, MA-NH

700
/ 850  ·  300–850 vs the local peer median  ·  target the local P90
Strong position
72.7% local percentile  ·  high peer-sample confidence
Scored as of July 19, 2026
186published rate records
4payers scored
46scoreable contract cells
158sanitized records

Aetna is the worst-paying contract we can score for John Charles Wain — 88.4% 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.

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Position by payer

Your median contracted rate vs the local peer median, per payer, for every payer we can score in Boston-Cambridge-Newton, MA-NH. 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.

PayerCodesYour medianLocal peer medianGapRateScore
Aetna 1 $237.37 $381.95 −$144.58 364
Bcbsnm 1 $400.87 $372.18 +$28.69 615
UnitedHealthcare 3 $798.62 $798.62 $0.00 644
Bcbs Ma 41 $632.53 $414.13 +$218.40 713

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.

PayerCPTYour rateLocal medianLocal P90Per-encounter gapPeers
Bcbs Ma 33864 $7,045.94 $6,104.13 $20,825.76 $13,779.82 49
Bcbs Ma 32666 $3,771.93 $3,771.93 $5,806.21 $2,034.28 51
Bcbs Ma 32656 $3,496.29 $3,496.29 $5,381.91 $1,885.62 18
Bcbs Ma 43235 $608.92 $608.71 $2,054.77 $1,445.85 737
UnitedHealthcare 31624 $323.09 $323.09 $1,196.72 $873.63 16
Bcbs Ma 33518 $894.49 $774.92 $1,575.62 $681.13 49
Bcbs Ma 33949 $906.26 $478.51 $1,520.68 $614.42 932
Bcbs Ma 75989 $387.66 $387.66 $788.13 $400.47 18
Bcbs Ma 31624 $575.96 $571.47 $886.59 $310.63 1195
Bcbs Ma 99292 $387.50 $234.59 $686.72 $299.22 1949

What insurers pay nationally for these codes: 43235 · 99292

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