Gary Gordon Benjamin
radiology · Seattle-Tacoma-Bellevue, WA
Moda Or is the worst-paying contract we can score for Gary Gordon Benjamin. 85.2% of peers, paid by the same payer for the same codes, 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 peer median, per payer, for every payer we can score in Seattle-Tacoma-Bellevue, WA. 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 | Basis | Your median | Peer median | Gap | RateScore |
|---|---|---|---|---|---|---|
| Moda Or | 45 | Local | $63.75 | $109.49 | −$45.74 | 381 |
| Centene | 50 | Local | $83.79 | $139.32 | −$55.53 | 413 |
| Aetna | 7 | Local | $44.48 | $48.90 | −$4.42 | 425 |
| Aetna Ca | 7 | Local | $36.00 | $49.87 | −$13.87 | 432 |
| Cigna | 11 | Local | $54.85 | $54.85 | $0.00 | 549 |
| UnitedHealthcare | 3 | Local | $666.51 | $666.51 | $0.00 | 575 |
| Anthem National | 177 | Local | $193.41 | $126.10 | +$67.31 | 739 |
| Regence Or Wa 4 | 59 | Mixed | $105.08 | $98.16 | +$6.92 | 822 |
Documented reimbursement opportunity
The largest per-encounter gaps to the P90 target, code by code. Modeled from published rates, not guaranteed, per encounter, not annualized.
| Payer | CPT | Basis | Your rate | Peer median | P90 target | Per-encounter gap | Peers |
|---|---|---|---|---|---|---|---|
| Moda Or | 64635 | Local | $327.93 | $401.04 | $1,394.82 | $1,066.89 | 128 |
| Moda Or | 64633 | Local | $333.03 | $400.33 | $1,376.79 | $1,043.76 | 128 |
| Anthem National | 28296 | Local | $1,196.34 | $1,322.20 | $2,193.79 | $997.45 | 3123 |
| Anthem National | 23472 | Local | $3,419.15 | $2,936.50 | $4,377.50 | $958.35 | 3118 |
| Anthem National | 43245 | Local | $411.87 | $370.67 | $1,330.42 | $918.55 | 3122 |
| Centene | 95810 | Local | $703.61 | $1,091.66 | $1,536.42 | $832.81 | 1089 |
| Regence Or Wa 4 | 64633 | Local | $491.32 | $612.61 | $1,181.13 | $689.81 | 2423 |
| Anthem National | 45384 | Local | $621.50 | $477.26 | $1,281.00 | $659.50 | 3121 |
| UnitedHealthcare | 32408 | Local | $1,894.76 | $1,894.76 | $2,495.30 | $600.54 | 9 |
| Moda Or | 27095 | Local | $122.91 | $159.14 | $713.75 | $590.84 | 128 |
What insurers pay nationally for these codes: 64635 · 64633 · 28296 · 23472 · 43245 · 95810 · 45384
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