Pathmaja Paramsothy
cardio · Seattle-Tacoma-Bellevue, WA
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 |
|---|---|---|---|---|---|---|
| Regence Or Wa 4 | 59 | Mixed | $103.85 | $98.16 | +$5.69 | 672 |
| Centene | 18 | Local | $241.51 | $209.78 | +$31.73 | 703 |
| Anthem National | 177 | Local | $212.36 | $126.10 | +$86.26 | 810 |
| Aetna Ca | 1 | Local | $151.57 | $105.22 | +$46.35 | 845 |
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 |
|---|---|---|---|---|---|---|---|
| Anthem National | 28296 | Local | $1,496.06 | $1,322.20 | $2,193.79 | $697.73 | 3123 |
| Regence Or Wa 4 | 64633 | Local | $497.08 | $612.61 | $1,181.13 | $684.05 | 2423 |
| Anthem National | 43239 | Local | $390.44 | $515.50 | $899.60 | $509.16 | 3135 |
| Anthem National | 45385 | Local | $715.18 | $530.37 | $1,194.91 | $479.73 | 3128 |
| Regence Or Wa 4 | 64635 | National | $497.95 | $618.16 | — | $120.21 | 2423 |
| Regence Or Wa 4 | 62323 | Local | $256.34 | $360.82 | $662.00 | $405.66 | 2424 |
| Anthem National | 64634 | Local | $190.46 | $137.71 | $575.86 | $385.40 | 3134 |
| Anthem National | 43235 | Local | $347.59 | $284.98 | $687.00 | $339.41 | 3131 |
| Anthem National | 64636 | Local | $167.60 | $120.41 | $499.85 | $332.25 | 3137 |
| Anthem National | 62323 | Local | $282.83 | $354.63 | $614.01 | $331.18 | 3140 |
What insurers pay nationally for these codes: 28296 · 64633 · 43239 · 45385 · 64635 · 62323 · 64634 · 43235 · 64636
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