RateScore · NPI 1730307976

John T Matthews

York-Hanover, PA

663
/ 850  ·  300-850 vs the LOCAL peer median; target = local P90  ·  Local · metro
Fair position
65.9% local percentile  ·  high peer-sample confidence
Scored as of August 19, 2026
576published rate records
2payers scored
21scoreable contract cells
405sanitized records

Capital Bc Pa is the worst-paying contract we can score for John T Matthews. 44.7% 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 York-Hanover, PA. 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.

PayerCodesBasisYour medianLocal peer medianGapRateScore
Capital Bc Pa 18 Local $103.59 $85.86 +$17.73 604
Bcbsnm 3 Local $104.01 $103.99 +$0.02 669

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.

PayerCPTBasisYour rateLocal peer medianLocal P90Per-encounter gapPeers
Bcbsnm 11055 Local $85.04 $85.04 $99.83 $14.79 619
Bcbsnm 11056 Local $104.01 $103.99 $118.14 $14.13 658
Capital Bc Pa G0438 Local $307.81 $267.98 $307.82 $0.01 34

What insurers pay nationally for these codes: 11055 · 11056

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