Keith R Hoerning
New York-Newark-Jersey City, NY-NJ
Empire BlueCross BlueShield (NY file) is the worst-paying contract we can score for Keith R Hoerning — 65.3% 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 New York-Newark-Jersey City, NY-NJ. 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 |
|---|---|---|---|---|---|
| Empire BlueCross BlueShield (NY file) | 9 | $96.01 | $81.17 | +$14.84 | 491 |
| Aetna | 8 | $26.80 | $31.00 | −$4.20 | 497 |
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 |
|---|---|---|---|---|---|---|
| Empire BlueCross BlueShield (NY file) | 99215 | $197.89 | $124.95 | $724.31 | $526.42 | 1277 |
| Empire BlueCross BlueShield (NY file) | G0439 | $151.74 | $240.30 | $557.77 | $406.03 | 685 |
| Empire BlueCross BlueShield (NY file) | 99232 | $97.52 | $199.66 | $370.47 | $272.95 | 929 |
| Empire BlueCross BlueShield (NY file) | 99238 | $98.39 | $143.89 | $228.61 | $130.22 | 180 |
| Empire BlueCross BlueShield (NY file) | 69210 | $96.01 | $81.17 | $225.96 | $129.95 | 104 |
| Aetna | 90653 | $98.15 | $98.16 | $208.09 | $109.94 | 311 |
| Aetna | 99490 | $30.39 | $57.76 | $100.22 | $69.83 | 332 |
| Empire BlueCross BlueShield (NY file) | 96138 | $55.81 | $66.24 | $105.29 | $49.48 | 11 |
| Aetna | 93000 | $22.54 | $33.74 | $68.36 | $45.82 | 1533 |
| Aetna | 99458 | $59.35 | $40.50 | $92.27 | $32.92 | 109 |
What insurers pay nationally for these codes: 99215 · 96138 · 93000
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