Blue Cross Blue Shield · Michigan · commercial in-network
Blue Cross Blue Shield negotiated rates in Michigan
How Blue Cross Blue Shield's Michigan rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Michigan at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
100
0% above the Michigan median
Rank in state
3 of 4
Cigna 123 · UHC 106 · BCBS 100 · Aetna 92
vs own national
94
BCBS's level vs its national median
Codes where highest
34%
of 228 codes
What the data shows
Generated from Michigan and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 3rd of 4 payers in Michigan with a rate index of 100 (100 = the Michigan market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 34% of codes in Michigan; Cigna leads with an index of 123 in the files analyzed.
3
Blue Cross Blue Shield's Michigan rates sit 6% below its own national level, the 30th highest of its 51 states.
4
Largest premium over the Michigan market: CPT 93298 (Rem interrog dev eval scrms) at 421% of market; largest discount: CPT 66991 (Xcapsl ctrc rmvl insj 1+) at 64%.
5
In Michigan, BCBS rates come from 34 licensee file sets; the largest is BCBS MI (800 sampled providers).
How the four payers compare in Michigan
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Cigna | 123 | 1 | 87% | 93 | |
| UnitedHealthcare | 106 | 2 | 44% | 664 | |
| Blue Cross Blue Shield | 100 | 3 | 34% | 846 | |
| Aetna | 92 | 4 | 1% | 707 |
Where Blue Cross Blue Shield pays most and least against the Michigan market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $159 | $38 | +321% | 121 |
| 93297 Rem interrog dev eval icpms | $94 | $36 | +162% | 121 |
| 92242 Fluorescein&icg angiography | $520 | $304 | +71% | 102 |
| 92235 Fluorescein angrph mltiframe | $251 | $158 | +59% | 102 |
| 73564 X-ray exam knee 4 or more | $82 | $55 | +47% | 98 |
| 73562 X-ray exam of knee 3 | $70 | $48 | +45% | 98 |
| 73030 X-ray exam of shoulder | $59 | $41 | +43% | 98 |
| 88342 Imhchem/imcytchm 1st antb | $170 | $120 | +42% | 102 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 66991 Xcapsl ctrc rmvl insj 1+ | $562 | $879 | -36% | 100 |
| 20550 Njx 1 tendon sheath/ligament | $42 | $57 | -26% | 99 |
| 65855 Trabeculoplasty laser surg | $210 | $276 | -24% | 102 |
| 51700 Irrigation of bladder | $32 | $40 | -20% | 107 |
| 68761 Close tear duct opening | $127 | $156 | -19% | 102 |
| 11102 Tangntl bx skin single les | $40 | $49 | -19% | 102 |
| 92020 Gonioscopy | $19 | $24 | -18% | 102 |
| 92136 Ophthalmic biometry | $46 | $57 | -18% | 101 |
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 Michigan
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| BCBS MI | 800 |
| Community Insurance Company | 97 |
| HealthKeepers, Inc. | 65 |
| Healthy Alliance Life Insurance Company | 31 |
| Anthem (Elevance) | 18 |
| BCBS IL | 16 |
| BCBS TX | 15 |
| BCBS NC | 11 |
| BCBS MT | 8 |
| BCBS TN | 7 |
| Regence | 6 |
| Premera | 6 |
| BCBS MN | 5 |
| HMO Colorado, Inc. | 4 |
| BS CA | 4 |
| Matthew Thornton Health Plan, Inc. | 4 |
| Blue Shield of California Life & Health Insurance Company | 4 |
| Carefirst BCBS | 4 |
| Blue Cross Blue Shield of North Dakota | 4 |
| BCBS OK | 3 |
| Capital BC | 3 |
| Capital BlueCross | 3 |
| Wellmark | 3 |
| Compcare Health Services Insurance Corporation | 2 |
| Excellus BCBS | 2 |
| BCBS KS | 1 |
| BCBS AL | 1 |
| BCBS NJ (Horizon) | 1 |
| BCBS NM | 1 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 1 |
| Horizon Healthcare of New Jersey | 1 |
| BCBS MA | 1 |
| BCBS RI | 1 |
| Blue Cross Blue Shield of Wyoming | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Michigan?
Blue Cross Blue Shield ranks 3rd of 4 in Michigan with an index of 100. It is highest on 34% of codes.
Are Blue Cross Blue Shield's Michigan rates above or below its national level?
About 6% below.
Which procedure does Blue Cross Blue Shield pay most above market in Michigan?
CPT 93298 (Rem interrog dev eval scrms), at 421% of the Michigan 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 Michigan?
Compare your negotiated rates for these codes with Michigan medians for each payer.