Ear Care Pllc Negotiated Rates & Price Benchmarks (The Colony, TX)
Benchmark negotiated rates for Ear Care Pllc across common Exclusive Provider Organization procedures, sourced from payer Transparency in Coverage machine-readable files.
About this Exclusive Provider Organization rate data
Gigasheet collects negotiated rates published by every payer under the federal Transparency in Coverage rule, then normalizes and cleanses them into a single analysis-ready dataset. We enrich those rates with provider, geographic, and reimbursement data from proprietary and open source healthcare intelligence, then benchmark every rate against Medicare, peer providers, and the local market.
For Ear Care Pllc, that covers common Exclusive Provider Organization procedures across Aetna, BCBS, Cigna, and UnitedHealthcare. (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
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How this is calculated
This provider's published rates, compared code by code against the market they compete in.
This provider's negotiated rates, keyed to NPI 1386928612.
For each code, negotiated rates from comparable Exclusive Provider Organization providers in the The Colony market form a distribution. Its median and percentile bands anchor the benchmark, alongside Medicare reference rates.
Each procedure is scored against its market distribution for the same code. Above, at, or below market reflects where this provider's rate sits relative to that market.
The score above is a blended view of this provider's rate position, produced by Gigasheet's proprietary methodology. It is rooted in published Transparency in Coverage data and normalized for statistical comparison. Position can vary significantly from one payer or procedure to the next. Upgrade to full access to see the evidence behind the Rate Score, including payer-level and procedure-level detail.
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About Price Transparency Data
Where do these rates come from?
Gigasheet processes raw payer data through proprietary cleaning, normalization, and enrichment methods to deliver best-in-class, analysis-ready rate intelligence.
Are these real contracted rates?
Yes. These are payer-published negotiated rates from Transparency in Coverage files required under federal price transparency rules. The free report includes a sample; full rate detail is available in Gigasheet.
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