A standing snapshot of the El Paso market, built from the four major national insurers' public in-network files. These are market statistics only — no practice-specific data appears here.
Gastroenterology and ophthalmology are the only El Paso specialties published here. We parsed the same insurer files for ENT and dermatology, but too few local groups disclose those codes for a median to mean anything — on ENT only one of the four insurers cleared our minimum of eight distinct tax IDs per figure. We would rather show nothing than a number we do not trust. If you are an El Paso ENT or dermatology practice, get in touch and we can still compare your own disclosed rates directly: hello@fair-rate.com.
Median disclosed professional rate for the highest-volume ophthalmology procedures, by insurer. The distance between the columns is money left on the table for a practice anchored to the wrong insurer.
Swipe the table sideways to see every insurer and Medicare →
| CPT | Procedure | Cigna | UHC | BCBSTX | Aetna | Medicare |
|---|---|---|---|---|---|---|
| 66984 | Cataract surgery with IOL insertion | $506 | $722 | $656 | $572 | $448 |
| 66821 | YAG laser capsulotomy | $288 | $351 | $376 | $328 | $265 |
| 65855 | Laser trabeculoplasty (SLT) | $227 | $278 | $296 | $261 | $237 |
| 67028 | Intravitreal injection | $106 | $115 | $137 | — | $110 |
| 92014 | Comprehensive eye exam, established patient | $117 | $141 | $148 | $97 | $123 |
| 92004 | Comprehensive eye exam, new patient | $138 | $169 | $175 | $115 | $144 |
Median of unique tax-ID × rate observations per code and insurer, restricted to ophthalmology-taxonomy NPIs practicing in El Paso-area counties. Surgical rates are the facility-setting professional fee (ASC / hospital outpatient); exams and injections are the office fee (POS 11). Medicare is the final CY2026 Physician Fee Schedule, El Paso locality, matched to setting. Figures rounded; individual practice rates vary around each median — see below. An em dash means that insurer does not publish the code in a directly comparable form, or that too few groups disclose it for a median to mean anything. Sample size: each median above rests on 8–19 distinct tax IDs. A median over few groups is a weaker signal than one over many.
The insurer spread is only half the story. On a single insurer, the gap between a practice at the 10th percentile and one at the 90th reaches 1.6× on high-volume surgical codes. Two eye groups a few miles apart, same insurer, can be paid very differently for an identical procedure.
This is the number a practice can move. A group sitting near an insurer's floor, holding documented evidence of the disclosed median, has a concrete, data-backed case for parity at renewal.
| 10th percentile group | $558 |
| Median group | $722 |
| 90th percentile group | $913 |
A practice at the low end earns roughly 39% less than one at the high end for the same procedure, with the same insurer, in the same city.
Three independent public sources, each doing a specific job. Nothing here touches claims data or any patient-level information.
The Transparency-in-Coverage disclosures — negotiated professional rates by tax ID and NPI, per code. The primary source, published monthly by each insurer.
2026 hospital files add what insurers actually paid, drawn from remittance data, with claim counts — a cross-check on the negotiated rates and their real volume.
The CY2026 Physician Fee Schedule at the El Paso locality — the neutral yardstick every insurer contract is quoted against.