Blue Cross Blue Shield · Georgia · commercial in-network
Blue Cross Blue Shield negotiated rates in Georgia
How Blue Cross Blue Shield's Georgia rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Georgia at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
98
2% below the Georgia median
Rank in state
3 of 4
UHC 115 · Cigna 105 · BCBS 98 · Aetna 83
vs own national
122
BCBS's level vs its national median
Codes where highest
10%
of 228 codes
What the data shows
Generated from Georgia and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 3rd of 4 payers in Georgia with a rate index of 98 (100 = the Georgia market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 10% of codes in Georgia; UnitedHealthcare leads with an index of 115 in the files analyzed.
3
Blue Cross Blue Shield's Georgia rates sit 22% above its own national level, the 13th highest of its 51 states.
4
Largest premium over the Georgia market: CPT 96413 (Chemo iv infusion 1 hr) at 172% of market; largest discount: CPT 88313 (Special stains group 2) at 65%.
5
In Georgia, BCBS rates come from 34 licensee file sets; the largest is Community Insurance Company (890 sampled providers).
How the four payers compare in Georgia
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 115 | 1 | 61% | 780 | |
| Cigna | 105 | 2 | 27% | 829 | |
| Blue Cross Blue Shield | 98 | 3 | 10% | 944 | |
| Aetna | 83 | 4 | 2% | 755 |
Where Blue Cross Blue Shield pays most and least against the Georgia market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 96413 Chemo iv infusion 1 hr | $434 | $252 | +72% | 120 |
| 88342 Imhchem/imcytchm 1st antb | $152 | $107 | +42% | 96 |
| 88305 Tissue exam by pathologist | $99 | $71 | +38% | 210 |
| 93298 Rem interrog dev eval scrms | $90 | $67 | +34% | 125 |
| 90960 Esrd srv 4 visits p mo 20+ | $678 | $521 | +30% | 118 |
| 46221 Ligation of hemorrhoid(s) | $524 | $424 | +24% | 120 |
| 70551 Mri brain stem w/o dye | $643 | $520 | +24% | 125 |
| 77080 Dxa bone density axial | $114 | $93 | +23% | 122 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 88313 Special stains group 2 | $43 | $67 | -35% | 114 |
| 71271 Ct thorax lung cancer scr c- | $186 | $275 | -32% | 125 |
| 99426 Prin care mgmt staff 1st 30 | $63 | $92 | -31% | 116 |
| 64566 Neuroeltrd stim post tibial | $57 | $83 | -31% | 117 |
| 92014 Compre oph exam est pt 1/> | $100 | $139 | -28% | 107 |
| 92242 Fluorescein&icg angiography | $327 | $449 | -27% | 104 |
| 92004 Compre oph exam new pt 1/> | $122 | $167 | -27% | 107 |
| 74174 Cta abd&plvs w/contrast | $451 | $601 | -25% | 125 |
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 Georgia
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Community Insurance Company | 890 |
| HealthKeepers, Inc. | 874 |
| BCBS NC | 42 |
| Healthy Alliance Life Insurance Company | 19 |
| BCBS TX | 17 |
| Anthem (Elevance) | 17 |
| BCBS AL | 12 |
| BCBS IL | 11 |
| BCBS MI | 9 |
| BCBS TN | 9 |
| BCBS NJ (Horizon) | 8 |
| Horizon Healthcare of New Jersey | 8 |
| Matthew Thornton Health Plan, Inc. | 6 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 6 |
| Carefirst BCBS | 4 |
| BCBS MN | 4 |
| BCBS RI | 4 |
| Excellus BCBS | 4 |
| BCBS MA | 4 |
| HMO Colorado, Inc. | 4 |
| Regence | 3 |
| Compcare Health Services Insurance Corporation | 3 |
| BCBS OK | 3 |
| Blue Shield of California Life & Health Insurance Company | 3 |
| BS CA | 3 |
| Wellmark | 2 |
| BCBS KS | 2 |
| Blue Cross Blue Shield of North Dakota | 2 |
| BCBS MT | 2 |
| Premera | 1 |
| BCBS AZ | 1 |
| Capital BC | 1 |
| BCBS HI | 1 |
| Capital BlueCross | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Georgia?
Blue Cross Blue Shield ranks 3rd of 4 in Georgia with an index of 98. It is highest on 10% of codes.
Are Blue Cross Blue Shield's Georgia rates above or below its national level?
About 22% above.
Which procedure does Blue Cross Blue Shield pay most above market in Georgia?
CPT 96413 (Chemo iv infusion 1 hr), at 172% of the Georgia 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 Georgia?
Compare your negotiated rates for these codes with Georgia medians for each payer.