RateScore · NPI 1164422291

Gulnar Balsara

Philadelphia-Camden-Wilmington, PA-NJ-DE-MD

349
/ 850  ·  300-850 vs the LOCAL peer median; target = local P90  ·  Local · metro
Critical: well below local peers
8.9% local percentile  ·  high peer-sample confidence
Scored as of August 18, 2026
36published rate records
2payers scored
14scoreable contract cells
24sanitized records

Cigna is the worst-paying contract we can score for Gulnar Balsara. 92.9% 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 Philadelphia-Camden-Wilmington, PA-NJ-DE-MD. 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
Cigna 12 Local $53.09 $101.52 −$48.43 339
Aetna 2 Local $35.71 $37.16 −$1.45 561

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
Cigna 88309 Local $162.70 $443.66 $443.66 $280.96 15
Cigna 88307 Local $120.95 $311.35 $311.35 $190.40 24
Cigna 88173 Local $87.64 $133.56 $191.13 $103.49 12
Cigna 88312 Local $30.88 $131.45 $131.85 $100.97 16
Cigna 88313 Local $17.67 $104.97 $116.24 $98.57 24
Cigna 88304 Local $31.51 $46.05 $101.68 $70.17 20
Cigna 88305 Local $69.39 $53.69 $132.62 $63.23 33
Cigna 88342 Local $56.00 $101.35 $110.04 $54.04 30
Cigna 88341 Local $50.17 $92.00 $97.23 $47.06 29
Aetna 88305 Local $54.38 $54.38 $98.27 $43.89 59
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