RateScore · NPI 1164452140

Lisa A Nigro

Cincinnati, OH-KY-IN

770
/ 850  ·  300-850 vs the LOCAL peer median; target = local P90  ·  Local · metro
Strong position
85.4% local percentile  ·  high peer-sample confidence
Scored as of August 18, 2026
695published rate records
3payers scored
16scoreable contract cells
364sanitized records

Anthem Blue Cross Blue Shield (OH file) is the worst-paying contract we can score for Lisa A Nigro. 90.6% 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 Cincinnati, OH-KY-IN. 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
Anthem Blue Cross Blue Shield (OH file) 1 Local $269.16 $300.00 −$30.84 352
Aetna 1 Local $323.30 $390.00 −$66.70 428
Centene 14 Local $97.90 $54.20 +$43.70 791

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
Aetna 00811 Local $323.30 $390.00 $486.38 $163.08 45
Anthem Blue Cross Blue Shield (OH file) 00813 Local $269.16 $300.00 $416.73 $147.57 16
Centene 11056 Local $25.53 $27.36 $117.85 $92.32 5174
Centene 10060 Local $189.20 $119.58 $230.74 $41.54 6578
Centene 11301 Local $107.02 $136.00 $140.30 $33.28 2176
Centene 92004 Local $151.97 $142.03 $171.72 $19.75 6019
Centene 98941 Local $39.71 $31.54 $57.52 $17.81 3529
Centene 92014 Local $128.87 $120.84 $146.00 $17.13 6048
Centene 98940 Local $27.54 $21.88 $40.08 $12.54 4324
Centene 92083 Local $93.18 $59.73 $97.00 $3.82 6800

What insurers pay nationally for these codes: 11056 · 10060 · 11301 · 92004 · 98941 · 92014 · 98940 · 92083

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