{
 "built_for": "Wellness 007, 2026-11-11",
 "title": "Same doctor, same visit, different price",
 "headline": {
  "median_high_to_low": 1.452,
  "p90_high_to_low": 1.808,
  "pairs_2plus_insurers": 9254
 },
 "by_code": [
  {
   "code": "99203",
   "label": "New patient, low complexity",
   "medicare_dallas_2026": 117.06,
   "insurers": [
    {
     "payer": "BCBSTX",
     "n_providers": 789,
     "median_pct": 107.0,
     "p10_pct": 80.6,
     "p90_pct": 141.6
    },
    {
     "payer": "UnitedHealthcare",
     "n_providers": 617,
     "median_pct": 138.7,
     "p10_pct": 106.1,
     "p90_pct": 170.5
    },
    {
     "payer": "Cigna",
     "n_providers": 601,
     "median_pct": 139.0,
     "p10_pct": 101.0,
     "p90_pct": 145.2
    },
    {
     "payer": "Aetna",
     "n_providers": 409,
     "median_pct": 98.4,
     "p10_pct": 77.8,
     "p90_pct": 131.0
    }
   ],
   "pairs_2plus_insurers": 641,
   "median_high_to_low": 1.465,
   "p90_high_to_low": 1.931
  },
  {
   "code": "99204",
   "label": "New patient, moderate complexity",
   "medicare_dallas_2026": 176.67,
   "insurers": [
    {
     "payer": "BCBSTX",
     "n_providers": 1609,
     "median_pct": 109.3,
     "p10_pct": 90.0,
     "p90_pct": 144.3
    },
    {
     "payer": "UnitedHealthcare",
     "n_providers": 1410,
     "median_pct": 156.5,
     "p10_pct": 110.8,
     "p90_pct": 172.6
    },
    {
     "payer": "Cigna",
     "n_providers": 1372,
     "median_pct": 137.8,
     "p10_pct": 107.4,
     "p90_pct": 143.8
    },
    {
     "payer": "Aetna",
     "n_providers": 869,
     "median_pct": 115.4,
     "p10_pct": 76.9,
     "p90_pct": 131.0
    }
   ],
   "pairs_2plus_insurers": 1439,
   "median_high_to_low": 1.448,
   "p90_high_to_low": 1.899
  },
  {
   "code": "99205",
   "label": "New patient, high complexity",
   "medicare_dallas_2026": 235.73,
   "insurers": [
    {
     "payer": "BCBSTX",
     "n_providers": 601,
     "median_pct": 105.1,
     "p10_pct": 90.1,
     "p90_pct": 131.8
    },
    {
     "payer": "UnitedHealthcare",
     "n_providers": 593,
     "median_pct": 149.0,
     "p10_pct": 118.1,
     "p90_pct": 163.4
    },
    {
     "payer": "Cigna",
     "n_providers": 592,
     "median_pct": 136.4,
     "p10_pct": 114.4,
     "p90_pct": 142.5
    },
    {
     "payer": "Aetna",
     "n_providers": 321,
     "median_pct": 93.5,
     "p10_pct": 76.2,
     "p90_pct": 123.6
    }
   ],
   "pairs_2plus_insurers": 595,
   "median_high_to_low": 1.426,
   "p90_high_to_low": 1.75
  },
  {
   "code": "99213",
   "label": "Established patient, low complexity",
   "medicare_dallas_2026": 94.96,
   "insurers": [
    {
     "payer": "BCBSTX",
     "n_providers": 2666,
     "median_pct": 97.9,
     "p10_pct": 79.5,
     "p90_pct": 116.9
    },
    {
     "payer": "UnitedHealthcare",
     "n_providers": 2385,
     "median_pct": 116.9,
     "p10_pct": 96.2,
     "p90_pct": 140.9
    },
    {
     "payer": "Cigna",
     "n_providers": 2344,
     "median_pct": 126.0,
     "p10_pct": 101.8,
     "p90_pct": 145.5
    },
    {
     "payer": "Aetna",
     "n_providers": 1436,
     "median_pct": 84.3,
     "p10_pct": 78.1,
     "p90_pct": 130.0
    }
   ],
   "pairs_2plus_insurers": 2427,
   "median_high_to_low": 1.455,
   "p90_high_to_low": 1.797
  },
  {
   "code": "99214",
   "label": "Established patient, moderate complexity",
   "medicare_dallas_2026": 135.25,
   "insurers": [
    {
     "payer": "BCBSTX",
     "n_providers": 3154,
     "median_pct": 94.8,
     "p10_pct": 80.4,
     "p90_pct": 107.5
    },
    {
     "payer": "UnitedHealthcare",
     "n_providers": 2846,
     "median_pct": 119.0,
     "p10_pct": 99.7,
     "p90_pct": 149.0
    },
    {
     "payer": "Cigna",
     "n_providers": 2819,
     "median_pct": 133.9,
     "p10_pct": 103.8,
     "p90_pct": 144.5
    },
    {
     "payer": "Aetna",
     "n_providers": 1698,
     "median_pct": 98.3,
     "p10_pct": 77.5,
     "p90_pct": 130.0
    }
   ],
   "pairs_2plus_insurers": 2900,
   "median_high_to_low": 1.462,
   "p90_high_to_low": 1.786
  },
  {
   "code": "99215",
   "label": "Established patient, high complexity",
   "medicare_dallas_2026": 191.87,
   "insurers": [
    {
     "payer": "BCBSTX",
     "n_providers": 1270,
     "median_pct": 94.7,
     "p10_pct": 78.4,
     "p90_pct": 115.5
    },
    {
     "payer": "UnitedHealthcare",
     "n_providers": 1244,
     "median_pct": 115.9,
     "p10_pct": 100.3,
     "p90_pct": 141.1
    },
    {
     "payer": "Cigna",
     "n_providers": 1231,
     "median_pct": 137.2,
     "p10_pct": 104.0,
     "p90_pct": 143.4
    },
    {
     "payer": "Aetna",
     "n_providers": 674,
     "median_pct": 93.6,
     "p10_pct": 74.2,
     "p90_pct": 123.6
    }
   ],
   "pairs_2plus_insurers": 1252,
   "median_high_to_low": 1.442,
   "p90_high_to_low": 1.74
  }
 ],
 "bcbstx_networks": [
  {
   "network": "MyBlue Health HMO",
   "median_pct": 76.7,
   "provider_code_keys": 3894
  },
  {
   "network": "ParPlan",
   "median_pct": 79.5,
   "provider_code_keys": 8740
  },
  {
   "network": "Blue Choice PPO",
   "median_pct": 81.8,
   "provider_code_keys": 9660
  },
  {
   "network": "Blue Advantage HMO",
   "median_pct": 88.3,
   "provider_code_keys": 9266
  },
  {
   "network": "Blue Essentials",
   "median_pct": 97.6,
   "provider_code_keys": 9465
  },
  {
   "network": "Self-insured employer plans",
   "median_pct": 102.0,
   "provider_code_keys": 9974
  },
  {
   "network": "Blue Premier",
   "median_pct": 104.7,
   "provider_code_keys": 9095
  }
 ],
 "bcbstx_same_doctor_high_to_low": {
  "median_across_files": 1.484,
  "median_across_networks": 1.434,
  "pairs": 10089
 },
 "bcbstx_common_pairs": {
  "pairs": 2883,
  "median_pct_low": 76.7,
  "median_pct_high": 94.7
 },
 "claim_check": {
  "BCBSTX": {
   "posted_pairs": 98562,
   "pairs_with_2024_claim": 11892
  },
  "UnitedHealthcare": {
   "posted_pairs": 89009,
   "pairs_with_2024_claim": 10825
  },
  "Cigna": {
   "posted_pairs": 86339,
   "pairs_with_2024_claim": 10682
  },
  "Aetna": {
   "posted_pairs": 88367,
   "pairs_with_2024_claim": 11093
  }
 },
 "min_providers_per_cell": 11,
 "sources": {
  "rates": "Transparency in Coverage in-network rate files: BCBSTX, UnitedHealthcare, Cigna, Aetna (posted 2026-10 to 2026-11)",
  "claims": "CMS Medicare Physician and Other Practitioners by Provider and Service, data year 2024, Texas",
  "benchmark": "CMS 2026 Medicare Physician Fee Schedule, RVU26D, CF 33.4009, Dallas (MAC 04412, locality 11), non-facility"
 }
}