Alan L Spielberg
gi · New York-Newark-Jersey City, NY-NJ
Empire BlueCross BlueShield (NY file) is the worst-paying contract we can score for Alan L Spielberg — 69.9% 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) | 5 | $187.99 | $447.60 | −$259.61 | 465 |
| Aetna | 1 | $534.21 | $700.00 | −$165.79 | 494 |
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) | 45385 | $489.23 | $489.23 | $2,212.27 | $1,723.04 | 246 |
| Empire BlueCross BlueShield (NY file) | 43235 | $187.99 | $447.60 | $1,525.41 | $1,337.42 | 60 |
| Aetna | 45380 | $534.21 | $700.00 | $1,825.95 | $1,291.74 | 275 |
| Empire BlueCross BlueShield (NY file) | 43239 | $571.74 | $501.55 | $1,199.47 | $627.73 | 213 |
| Empire BlueCross BlueShield (NY file) | 99203 | $108.15 | $153.81 | $227.51 | $119.36 | 416 |
| Empire BlueCross BlueShield (NY file) | 99213 | $70.35 | $70.35 | $189.67 | $119.32 | 4875 |
What insurers pay nationally for these codes: 45385 · 43235 · 45380 · 43239 · 99203 · 99213
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