Blue Cross Blue Shield · Idaho · commercial in-network
Blue Cross Blue Shield negotiated rates in Idaho
How Blue Cross Blue Shield's Idaho rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Idaho at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
107
7% above the Idaho median
Rank in state
2 of 4
Aetna 112 · BCBS 107 · UHC 98 · Cigna 97
vs own national
120
BCBS's level vs its national median
Codes where highest
25%
of 228 codes
What the data shows
Generated from Idaho and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 2nd of 4 payers in Idaho with a rate index of 107 (100 = the Idaho market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 25% of codes in Idaho; Aetna leads with an index of 112 in the files analyzed.
3
Blue Cross Blue Shield's Idaho rates sit 20% above its own national level, the 15th highest of its 51 states.
4
Largest premium over the Idaho market: CPT 93298 (Rem interrog dev eval scrms) at 324% of market; largest discount: CPT 51700 (Irrigation of bladder) at 78%.
5
In Idaho, BCBS rates come from 36 licensee file sets; the largest is Regence (509 sampled providers).
How the four payers compare in Idaho
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Aetna | 112 | 1 | 38% | 491 | |
| Blue Cross Blue Shield | 107 | 2 | 25% | 547 | |
| UnitedHealthcare | 98 | 3 | 27% | 546 | |
| Cigna | 97 | 4 | 10% | 529 |
Where Blue Cross Blue Shield pays most and least against the Idaho market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $139 | $43 | +224% | 51 |
| 88312 Special stains group 1 | $178 | $86 | +107% | 87 |
| 88342 Imhchem/imcytchm 1st antb | $166 | $81 | +104% | 40 |
| 93297 Rem interrog dev eval icpms | $83 | $43 | +94% | 51 |
| 88313 Special stains group 2 | $114 | $61 | +86% | 47 |
| 88305 Tissue exam by pathologist | $113 | $64 | +78% | 87 |
| 76872 Us transrectal | $414 | $281 | +48% | 43 |
| 43255 Egd control bleeding any | $854 | $589 | +45% | 47 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 51700 Irrigation of bladder | $46 | $59 | -22% | 43 |
| 51702 Insert temp bladder cath | $38 | $49 | -22% | 43 |
| 99457 Rpm tx mgmt 1st 20 min | $44 | $57 | -22% | 146 |
| 51720 Treatment of bladder lesion | $66 | $84 | -22% | 43 |
| 52224 Cystoscopy and treatment | $305 | $388 | -21% | 43 |
| 52287 Cystoscopy chemodenervation | $255 | $323 | -21% | 43 |
| 52000 Cystourethroscopy | $122 | $154 | -21% | 43 |
| 55866 Laps surg prst8ect rpbic rad | $1,817 | $2,293 | -21% | 43 |
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 Idaho
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Regence | 509 |
| Premera | 76 |
| Community Insurance Company | 49 |
| Blue Cross Blue Shield of Wyoming | 33 |
| BCBS TX | 26 |
| BCBS MT | 23 |
| Healthy Alliance Life Insurance Company | 20 |
| HealthKeepers, Inc. | 20 |
| Blue Shield of California Life & Health Insurance Company | 12 |
| BS CA | 11 |
| Anthem (Elevance) | 9 |
| BCBS NC | 9 |
| BCBS IL | 8 |
| BCBS KS | 8 |
| Matthew Thornton Health Plan, Inc. | 7 |
| BCBS TN | 6 |
| BCBS MI | 5 |
| Wellmark | 4 |
| BCBS OK | 3 |
| BCBS NJ (Horizon) | 3 |
| BCBS MN | 3 |
| BCBS HI | 3 |
| Horizon Healthcare of New Jersey | 3 |
| Compcare Health Services Insurance Corporation | 2 |
| BCBS MA | 2 |
| BCBS MS | 2 |
| HMO Missouri, Inc. | 2 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 2 |
| BCBS NM | 2 |
| Carefirst BCBS | 2 |
| Capital BC | 1 |
| Excellus BCBS | 1 |
| Blue Cross Blue Shield of North Dakota | 1 |
| Blue Cross and Blue Shield of Nebraska | 1 |
| Capital BlueCross | 1 |
| BCBS RI | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Idaho?
Blue Cross Blue Shield ranks 2nd of 4 in Idaho with an index of 107. It is highest on 25% of codes.
Are Blue Cross Blue Shield's Idaho rates above or below its national level?
About 20% above.
Which procedure does Blue Cross Blue Shield pay most above market in Idaho?
CPT 93298 (Rem interrog dev eval scrms), at 324% of the Idaho 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 Idaho?
Compare your negotiated rates for these codes with Idaho medians for each payer.