Blue Cross Blue Shield · Alabama · commercial in-network
Blue Cross Blue Shield negotiated rates in Alabama
How Blue Cross Blue Shield's Alabama rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Alabama at a glance
Across 227 procedure codes for 8 specialties
Rate index vs state market
100
0% above the Alabama median
Rank in state
1 of 4
BCBS 100 · Aetna 100 · UHC 96 · Cigna 86
vs own national
86
BCBS's level vs its national median
Codes where highest
33%
of 227 codes
What the data shows
Generated from Alabama and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 1st of 4 payers in Alabama with a rate index of 100 (100 = the Alabama market median), across 227 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 33% of codes in Alabama; Blue Cross Blue Shield leads with an index of 100 in the files analyzed.
3
Blue Cross Blue Shield's Alabama rates sit 14% below its own national level, the 37th highest of its 51 states.
4
Largest premium over the Alabama market: CPT 92025 (Cptrized corneal topography) at 175% of market; largest discount: CPT 52224 (Cystoscopy and treatment) at 51%.
5
In Alabama, BCBS rates come from 34 licensee file sets; the largest is BCBS AL (794 sampled providers).
How the four payers compare in Alabama
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Blue Cross Blue Shield | 100 | 1 | 33% | 852 | |
| Aetna | 100 | 1 | 31% | 847 | |
| UnitedHealthcare | 96 | 3 | 31% | 719 | |
| Cigna | 86 | 4 | 5% | 837 |
Where Blue Cross Blue Shield pays most and least against the Alabama market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 92025 Cptrized corneal topography | $66 | $38 | +75% | 99 |
| 77080 Dxa bone density axial | $85 | $50 | +70% | 105 |
| 43242 Egd us fine needle bx/aspir | $852 | $526 | +62% | 99 |
| 17004 Destroy premal lesions 15/> | $220 | $139 | +58% | 124 |
| 78452 Ht muscle image spect mult | $815 | $531 | +54% | 202 |
| 43264 Ercp remove duct calculi | $1,069 | $729 | +47% | 99 |
| 15823 Blepharp upr eyelid xcsv skn | $876 | $598 | +46% | 99 |
| 27447 Total knee arthroplasty | $2,900 | $2,060 | +41% | 100 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 52224 Cystoscopy and treatment | $202 | $395 | -49% | 106 |
| 52287 Cystoscopy chemodenervation | $171 | $330 | -48% | 106 |
| 51700 Irrigation of bladder | $31 | $59 | -48% | 106 |
| 67840 Remove eyelid lesion | $150 | $271 | -44% | 99 |
| 51702 Insert temp bladder cath | $28 | $49 | -43% | 106 |
| 93312 Echo transesophageal | $238 | $411 | -42% | 112 |
| 51720 Treatment of bladder lesion | $51 | $86 | -41% | 106 |
| 20550 Njx 1 tendon sheath/ligament | $39 | $61 | -37% | 109 |
Where Blue Cross Blue Shield pays above and below its national level
Index vs the payer's own national median (100 = national)
Highest states
| State | Index | Prov. | |
|---|---|---|---|
| Alaska | 243 | 290 | |
| Wisconsin | 192 | 733 | |
| Minnesota | 171 | 671 | |
| North Dakota | 148 | 329 | |
| Wyoming | 145 | 256 |
Lowest states
| State | Index | Prov. | |
|---|---|---|---|
| Maryland | 63 | 758 | |
| Arizona | 66 | 479 | |
| Texas | 69 | 1,003 | |
| District of Columbia | 69 | 484 | |
| New Mexico | 74 | 562 |
Blue Cross Blue Shield licensees in Alabama
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| BCBS AL | 794 |
| Community Insurance Company | 114 |
| HealthKeepers, Inc. | 98 |
| BCBS TN | 71 |
| BCBS TX | 25 |
| BCBS NC | 21 |
| Healthy Alliance Life Insurance Company | 17 |
| Anthem (Elevance) | 16 |
| Matthew Thornton Health Plan, Inc. | 12 |
| BCBS MS | 11 |
| BCBS IL | 10 |
| Carefirst BCBS | 5 |
| Blue Shield of California Life & Health Insurance Company | 4 |
| Compcare Health Services Insurance Corporation | 4 |
| BS CA | 4 |
| BCBS MI | 4 |
| Regence | 4 |
| BCBS OK | 3 |
| Blue Cross Blue Shield of North Dakota | 3 |
| BCBS MN | 3 |
| BCBS AZ | 3 |
| Premera | 3 |
| BCBS RI | 2 |
| BCBS Kansas City | 2 |
| Wellmark | 2 |
| BCBS KS | 2 |
| Horizon Healthcare of New Jersey | 1 |
| BCBS MA | 1 |
| BCBS MT | 1 |
| Blue Cross and Blue Shield of Nebraska | 1 |
| BCBS NM | 1 |
| BCBS NJ (Horizon) | 1 |
| HMO Colorado, Inc. | 1 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Alabama?
Blue Cross Blue Shield ranks 1st of 4 in Alabama with an index of 100. It is highest on 33% of codes.
Are Blue Cross Blue Shield's Alabama rates above or below its national level?
About 14% below.
Which procedure does Blue Cross Blue Shield pay most above market in Alabama?
CPT 92025 (Cptrized corneal topography), at 175% of the Alabama median.
Methodology
How these numbers are calculated
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Is your Blue Cross Blue Shield contract at market in Alabama?
Compare your negotiated rates for these codes with Alabama medians for each payer.