Brian K Kelly
neurology · Philadelphia-Camden-Wilmington, PA-NJ-DE-MD
Cigna is the worst-paying contract we can score for Brian K Kelly — 95.4% 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.
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.
| Payer | Codes | Your median | Local peer median | Gap | RateScore |
|---|---|---|---|---|---|
| Cigna | 12 | $91.31 | $181.26 | −$89.95 | 325 |
| Aetna | 1 | $228.97 | $385.55 | −$156.58 | 387 |
| Highmark Blue Shield (PA file) | 11 | $129.59 | $184.63 | −$55.04 | 436 |
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.
| Payer | CPT | Your rate | Local median | Local P90 | Per-encounter gap | Peers |
|---|---|---|---|---|---|---|
| Cigna | 95816 | $240.64 | $522.80 | $733.16 | $492.52 | 12 |
| Cigna | 99284 | $86.39 | $184.98 | $386.82 | $300.43 | 67 |
| Aetna | 99205 | $228.97 | $385.55 | $453.00 | $224.03 | 418 |
| Cigna | 99205 | $161.64 | $243.67 | $343.38 | $181.74 | 262 |
| Cigna | 99223 | $141.06 | $259.92 | $311.22 | $170.16 | 399 |
| Cigna | 99204 | $97.22 | $204.64 | $254.76 | $157.54 | 581 |
| Highmark Blue Shield (PA file) | 99205 | $222.78 | $336.20 | $370.17 | $147.39 | 257 |
| Cigna | 99214 | $61.00 | $167.90 | $207.50 | $146.50 | 1004 |
| Highmark Blue Shield (PA file) | 99215 | $175.88 | $266.70 | $313.02 | $137.14 | 496 |
| Cigna | 99222 | $96.22 | $177.54 | $211.34 | $115.12 | 497 |
What insurers pay nationally for these codes: 95816 · 99284 · 99204 · 99214 · 99215
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