RateScore · NPI 1164446472

Martin Jay Kessler

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

389
/ 850  ·  300-850 vs the LOCAL peer median; target = local P90  ·  Local · metro
Critical: well below local peers
16.2% local percentile  ·  high peer-sample confidence
Scored as of July 19, 2026
36published rate records
2payers scored
17scoreable contract cells
14sanitized records

Cigna is the worst-paying contract we can score for Martin Jay Kessler. 84.6% 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 15 Local $31.46 $38.00 −$6.54 385
Aetna 2 Local $16.46 $15.25 +$1.21 602

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 99495 Local $152.29 $276.80 $330.79 $178.50 52
Cigna 99204 Local $97.22 $204.64 $254.76 $157.54 581
Cigna 99203 Local $82.46 $150.88 $197.70 $115.24 335
Cigna 99213 Local $54.50 $96.57 $146.51 $92.01 859
Cigna 99214 Local $165.05 $167.90 $207.50 $42.45 1004
Cigna 93000 Local $13.94 $28.04 $43.72 $29.78 171
Cigna 87426 Local $27.72 $34.80 $56.47 $28.75 37
Cigna 87880 Local $12.32 $14.97 $37.26 $24.94 25
Aetna 93000 Local $29.26 $27.21 $48.96 $19.70 329
Cigna 71046 Local $31.46 $38.00 $47.81 $16.35 97

What insurers pay nationally for these codes: 99204 · 99203 · 99213 · 99214 · 93000

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