Blue Cross Blue Shield negotiated rates in Florida
How Blue Cross Blue Shield's Florida rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Florida at a glance
What the data shows
Blue Cross Blue Shield ranks 2nd of 4 payers in Florida with a rate index of 107 (100 = the Florida market median), across 166 procedure codes.
Blue Cross Blue Shield has the highest median for only 34% of codes in Florida; UnitedHealthcare leads with an index of 112 in the files analyzed.
Blue Cross Blue Shield's Florida rates sit 11% below its own national level, the 34th highest of its 51 states.
Largest premium over the Florida market: CPT 93298 (Rem interrog dev eval scrms) at 303% of market; largest discount: CPT 88313 (Special stains group 2) at 65%.
In Florida, BCBS rates come from 35 licensee file sets; the largest is Community Insurance Company (114 sampled providers).
How the four payers compare in Florida
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 112 | 1 | 59% | 744 | |
| Blue Cross Blue Shield | 107 | 2 | 34% | 200 | |
| Cigna | 96 | 3 | 13% | 775 | |
| Aetna | 85 | 4 | 4% | 758 |
Where Blue Cross Blue Shield pays most and least against the Florida market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $100 | $33 | +203% | 16 |
| 76857 Us exam pelvic limited | $91 | $48 | +89% | 18 |
| 72110 X-ray exam l-2 spine 4/>vws | $78 | $42 | +85% | 17 |
| 76775 Us exam abdo back wall lim | $100 | $57 | +75% | 18 |
| 73630 X-ray exam of foot | $44 | $27 | +64% | 17 |
| 27447 Total knee arthroplasty | $2,758 | $1,715 | +61% | 19 |
| 73564 X-ray exam knee 4 or more | $58 | $36 | +59% | 18 |
| 73610 X-ray exam of ankle | $45 | $29 | +56% | 17 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 88313 Special stains group 2 | $29 | $44 | -35% | 16 |
| 88312 Special stains group 1 | $44 | $62 | -29% | 31 |
| 70551 Mri brain stem w/o dye | $262 | $356 | -26% | 49 |
| 72141 Mri neck spine w/o dye | $254 | $345 | -26% | 49 |
| 71250 Ct thorax dx c- | $173 | $233 | -26% | 49 |
| 71271 Ct thorax lung cancer scr c- | $152 | $200 | -24% | 53 |
| 72197 Mri pelvis w/o & w/dye | $451 | $574 | -22% | 49 |
| 74183 Mri abd w/o cntr flwd cntr | $454 | $575 | -21% | 49 |
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 Florida
| Licensee file set | Sampled providers |
|---|---|
| Community Insurance Company | 114 |
| HealthKeepers, Inc. | 69 |
| BCBS TX | 31 |
| Healthy Alliance Life Insurance Company | 30 |
| BCBS NC | 18 |
| Matthew Thornton Health Plan, Inc. | 17 |
| Anthem (Elevance) | 16 |
| BCBS IL | 12 |
| BCBS AL | 11 |
| BCBS MI | 11 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 9 |
| BCBS MA | 9 |
| BCBS TN | 9 |
| Compcare Health Services Insurance Corporation | 8 |
| Horizon Healthcare of New Jersey | 7 |
| BCBS NJ (Horizon) | 7 |
| BCBS NM | 7 |
| Carefirst BCBS | 6 |
| BS CA | 6 |
| Blue Shield of California Life & Health Insurance Company | 6 |
| BCBS MT | 5 |
| BCBS MN | 5 |
| Wellmark | 4 |
| BCBS AZ | 3 |
| Blue Cross and Blue Shield of Nebraska | 3 |
| Premera | 2 |
| Capital BlueCross | 2 |
| Excellus BCBS | 2 |
| Blue Cross and Blue Shield of Massachusetts, Inc. | 2 |
| Blue Cross Blue Shield of North Dakota | 2 |
| Regence | 2 |
| Capital BC | 2 |
| BCBS RI | 1 |
| BCBS VT | 1 |
| HMO Colorado, Inc. | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Florida?
Blue Cross Blue Shield ranks 2nd of 4 in Florida with an index of 107. It is highest on 34% of codes.
Are Blue Cross Blue Shield's Florida rates above or below its national level?
About 11% below.
Which procedure does Blue Cross Blue Shield pay most above market in Florida?
CPT 93298 (Rem interrog dev eval scrms), at 303% of the Florida 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 Florida?
Compare your negotiated rates for these codes with Florida medians for each payer.