What is the top of the local market (P90) for CPT 00811 under Anthem Blue Cross Blue Shield (VA) for Cincinnati, OH-KY-IN providers?

The P90, the top of the local market and Reddenda's target rate, is $287.57.

Reddenda · Rate Intelligence · Cincinnati, OH-KY-IN

00811 under Anthem Blue Cross Blue Shield (VA), for Cincinnati, OH-KY-IN providers

Name: Anthem Blue Cross Blue Shield (VA) rates for CPT 00811 among Cincinnati, OH-KY-IN providers
Creator: Reddenda

Local peer median $230 · Medium confidence

$230 local peer median. Anthem Blue Cross Blue Shield (VA)'s published rate file lists a local peer median of $230 for CPT 00811 among 220 indexed providers 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 the provider’s location. Blue Cross plans file separately per state and do not share rates, even for the same provider. The top of that filed distribution, the P90 target, is $287.57, 25% above the median. A provider billed below this median is being paid less than peers holding the identical Anthem Blue Cross Blue Shield (VA) contract for the identical code. Modeled from published rates, not guaranteed.

Local distribution · 220 providers · 220 rate records

P10

$200

P25

$230

Median

$230

P75

$230

P90 (target)

$287.57

P10$200

P25$230

Median (P50)$230

P75$230

P90 target$287.57

Peer basis: local peer distribution: same CPT, same payer file, same metro (CBSA) Benchmark: local peer median; never a national average Range: $200 – $367

The local peer median for CPT 00811 under Anthem Blue Cross Blue Shield (VA) for Cincinnati, OH-KY-IN providers is $230, drawn from 220 distinct providers.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (VA) to publish this rate
The bottom of the local market (P10) is $200 and the top (P90) is $287.57; the median-to-P90 spread is $57.57.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (VA) to publish this rate
The lowest published rate in this market is $200; the highest is $367.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (VA) to publish this rate
This benchmark is drawn from 220 individual rate records that Anthem Blue Cross Blue Shield (VA) itself published for this code in this metro.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (VA) to publish this rate
72.3% of indexed providers cluster at the single most common rate; the remainder shows a real, scoreable spread across the local market.Source: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (VA) to publish this rate
A federal No Surprises Act arbitrator may weigh up to four plan years of a provider's own contracted rate history and local market share when resolving a payment dispute over this exact code and payer.Source: 45 CFR §149.510(c)(4)(iii)(B)

220 providers bill this code to this payer in this metro.

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These are the rates Anthem Blue Cross Blue Shield (VA) publishes for CPT 00811 among Cincinnati, OH-KY-IN providers. Enter your NPI to see your own contracted rate against this peer curve, per payer and per code. Free, about 15 seconds, no card and no PHI.

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Documented reimbursement opportunity, modeled from published rates and never a guaranteed outcome.

Modeled from Anthem Blue Cross Blue Shield (VA)'s own published in-network rates, never guaranteed and never a national average. Peer basis: same CPT, same payer file, same metro (CBSA). Federal citation for the underlying obligation: the federal Transparency in Coverage Rule (45 CFR §147.212), which compels Anthem Blue Cross Blue Shield (VA) to publish this rate. Page generated 2026-08-23 23:45 UTC; the live index is queried in real time on every request.