Blue Cross Blue Shield negotiated rates in District of Columbia
How Blue Cross Blue Shield's District of Columbia rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in District of Columbia at a glance
What the data shows
Blue Cross Blue Shield ranks 4th of 4 payers in District of Columbia with a rate index of 66 (100 = the District of Columbia market median), across 228 procedure codes.
Blue Cross Blue Shield has the highest median for only 1% of codes in District of Columbia; UnitedHealthcare leads with an index of 142 in the files analyzed.
Blue Cross Blue Shield's District of Columbia rates sit 31% below its own national level, the 48th highest of its 51 states.
Largest premium over the District of Columbia market: CPT 88342 (Imhchem/imcytchm 1st antb) at 125% of market; largest discount: CPT 77280 (Ther rad simulaj field smpl) at 15%.
In District of Columbia, BCBS rates come from 36 licensee file sets; the largest is Carefirst BCBS (390 sampled providers).
How the four payers compare in District of Columbia
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 142 | 1 | 59% | 396 | |
| Cigna | 121 | 2 | 19% | 430 | |
| Aetna | 102 | 3 | 21% | 357 | |
| Blue Cross Blue Shield | 66 | 4 | 1% | 484 |
Where Blue Cross Blue Shield pays most and least against the District of Columbia market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 88342 Imhchem/imcytchm 1st antb | $103 | $82 | +25% | 31 |
| 14040 Tis trnfr f/c/c/m/n/a/g/h/f | $759 | $701 | +8% | 31 |
| 15260 Fth/gft fr n/e/e/l 20 sqcm/< | $1,027 | $949 | +8% | 31 |
| 14061 Tis trnfr e/n/e/l10.1-30sqcm | $993 | $921 | +8% | 31 |
| 17000 Destruct premalg lesion | $64 | $60 | +7% | 30 |
| 14041 Tis trnfr f/c/c/m/n/a/g/h/f | $925 | $878 | +5% | 31 |
| 13121 Cmplx rpr s/a/l 2.6-7.5 cm | $311 | $311 | +0% | 31 |
| 92235 Fluorescein angrph mltiframe | $145 | $145 | +0% | 48 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 77280 Ther rad simulaj field smpl | $36 | $246 | -85% | 31 |
| 92242 Fluorescein&icg angiography | $47 | $247 | -81% | 48 |
| 77066 Dx mammo incl cad bi | $45 | $203 | -78% | 121 |
| 71046 X-ray exam chest 2 views | $10 | $40 | -75% | 121 |
| 77049 Mri breast c-+ w/cad bi | $135 | $500 | -73% | 121 |
| 73610 X-ray exam of ankle | $16 | $57 | -72% | 34 |
| 93298 Rem interrog dev eval scrms | $19 | $59 | -68% | 75 |
| 93312 Echo transesophageal | $149 | $440 | -66% | 74 |
Where Blue Cross Blue Shield pays above and below its national level
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 District of Columbia
| Licensee file set | Sampled providers |
|---|---|
| Carefirst BCBS | 390 |
| Community Insurance Company | 313 |
| HealthKeepers, Inc. | 24 |
| Healthy Alliance Life Insurance Company | 19 |
| BCBS TX | 17 |
| BCBS NC | 16 |
| BCBS IL | 13 |
| Anthem (Elevance) | 11 |
| Blue Shield of California Life & Health Insurance Company | 9 |
| BS CA | 9 |
| Horizon Healthcare of New Jersey | 8 |
| BCBS MI | 8 |
| BCBS NJ (Horizon) | 8 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 6 |
| BCBS MA | 5 |
| BCBS KS | 5 |
| Compcare Health Services Insurance Corporation | 5 |
| BCBS HI | 5 |
| Blue Cross Blue Shield of North Dakota | 4 |
| Matthew Thornton Health Plan, Inc. | 4 |
| Excellus BCBS | 3 |
| BCBS RI | 3 |
| Wellmark | 2 |
| BCBS VT | 2 |
| BCBS OK | 2 |
| Blue Cross Blue Shield of Wyoming | 2 |
| BCBS Kansas City | 1 |
| BCBS MT | 1 |
| Blue Cross and Blue Shield of Nebraska | 1 |
| BCBS AL | 1 |
| Regence | 1 |
| Capital BC | 1 |
| Capital BlueCross | 1 |
| Premera | 1 |
| BCBS TN | 1 |
| HMO Colorado, Inc. | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in District of Columbia?
Blue Cross Blue Shield ranks 4th of 4 in District of Columbia with an index of 66. It is highest on 1% of codes.
Are Blue Cross Blue Shield's District of Columbia rates above or below its national level?
About 31% below.
Which procedure does Blue Cross Blue Shield pay most above market in District of Columbia?
CPT 88342 (Imhchem/imcytchm 1st antb), at 125% of the District of Columbia median.
Methodology
- 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 District of Columbia?
Compare your negotiated rates for these codes with District of Columbia medians for each payer.