Blue Cross Blue Shield · Arizona · commercial in-network
Blue Cross Blue Shield negotiated rates in Arizona
How Blue Cross Blue Shield's Arizona rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Arizona at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
82
18% below the Arizona median
Rank in state
4 of 4
UHC 115 · Cigna 102 · Aetna 91 · BCBS 82
vs own national
66
BCBS's level vs its national median
Codes where highest
5%
of 228 codes
What the data shows
Generated from Arizona and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 4th of 4 payers in Arizona with a rate index of 82 (100 = the Arizona market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 5% of codes in Arizona; UnitedHealthcare leads with an index of 115 in the files analyzed.
3
Blue Cross Blue Shield's Arizona rates sit 34% below its own national level, the 50th highest of its 51 states.
4
Largest premium over the Arizona market: CPT 67042 (Vit for macular hole) at 120% of market; largest discount: CPT 52648 (Laser surgery of prostate) at 47%.
5
In Arizona, BCBS rates come from 40 licensee file sets; the largest is BCBS AZ (324 sampled providers).
How the four payers compare in Arizona
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 115 | 1 | 64% | 699 | |
| Cigna | 102 | 2 | 29% | 698 | |
| Aetna | 91 | 3 | 3% | 719 | |
| Blue Cross Blue Shield | 82 | 4 | 5% | 479 |
Where Blue Cross Blue Shield pays most and least against the Arizona market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 67042 Vit for macular hole | $1,519 | $1,265 | +20% | 74 |
| 71046 X-ray exam chest 2 views | $44 | $38 | +17% | 57 |
| 93298 Rem interrog dev eval scrms | $105 | $94 | +12% | 49 |
| 93297 Rem interrog dev eval icpms | $62 | $56 | +11% | 48 |
| 93308 Tte f-up or lmtd | $119 | $108 | +10% | 47 |
| 22612 Arthrd pst tq 1ntrspc lumbar | $2,542 | $2,324 | +9% | 36 |
| 93351 Stress tte complete | $275 | $253 | +8% | 47 |
| 92235 Fluorescein angrph mltiframe | $158 | $146 | +8% | 74 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 52648 Laser surgery of prostate | $674 | $1,445 | -53% | 35 |
| 52000 Cystourethroscopy | $100 | $197 | -49% | 38 |
| 51700 Irrigation of bladder | $34 | $65 | -48% | 36 |
| 52332 Cystoscopy and treatment | $169 | $321 | -47% | 38 |
| 51720 Treatment of bladder lesion | $50 | $91 | -45% | 36 |
| 43255 Egd control bleeding any | $238 | $428 | -44% | 36 |
| 64566 Neuroeltrd stim post tibial | $37 | $65 | -44% | 37 |
| 99457 Rpm tx mgmt 1st 20 min | $23 | $39 | -41% | 94 |
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 Arizona
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| BCBS AZ | 324 |
| Community Insurance Company | 128 |
| HealthKeepers, Inc. | 68 |
| BCBS TX | 42 |
| Healthy Alliance Life Insurance Company | 37 |
| Blue Shield of California Life & Health Insurance Company | 29 |
| BS CA | 28 |
| Matthew Thornton Health Plan, Inc. | 19 |
| BCBS NC | 18 |
| Anthem (Elevance) | 17 |
| BCBS IL | 15 |
| Regence | 13 |
| BCBS MI | 11 |
| Wellmark | 10 |
| Premera | 9 |
| BCBS NM | 9 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 8 |
| BCBS MA | 8 |
| BCBS MN | 7 |
| BCBS TN | 6 |
| BCBS MT | 5 |
| Blue Cross Blue Shield of North Dakota | 5 |
| Blue Cross Blue Shield of Wyoming | 5 |
| Blue Cross and Blue Shield of Nebraska | 4 |
| BCBS KS | 3 |
| HMO Colorado, Inc. | 3 |
| BCBS OK | 3 |
| Compcare Health Services Insurance Corporation | 2 |
| Capital BlueCross | 2 |
| BCBS Kansas City | 2 |
| Excellus BCBS | 2 |
| BCBS HI | 2 |
| Capital BC | 2 |
| BCBS RI | 1 |
| Horizon Healthcare of New Jersey | 1 |
| BCBS AL | 1 |
| BCBS NJ (Horizon) | 1 |
| HMO Missouri, Inc. | 1 |
| Carefirst BCBS | 1 |
| BCBS MS | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Arizona?
Blue Cross Blue Shield ranks 4th of 4 in Arizona with an index of 82. It is highest on 5% of codes.
Are Blue Cross Blue Shield's Arizona rates above or below its national level?
About 34% below.
Which procedure does Blue Cross Blue Shield pay most above market in Arizona?
CPT 67042 (Vit for macular hole), at 120% of the Arizona 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 Arizona?
Compare your negotiated rates for these codes with Arizona medians for each payer.