Blue Cross Blue Shield negotiated rates in Nevada
How Blue Cross Blue Shield's Nevada rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Nevada at a glance
What the data shows
Blue Cross Blue Shield ranks 2nd of 4 payers in Nevada with a rate index of 105 (100 = the Nevada market median), across 227 procedure codes.
Blue Cross Blue Shield has the highest median for only 34% of codes in Nevada; UnitedHealthcare leads with an index of 110 in the files analyzed.
Blue Cross Blue Shield's Nevada rates sit 6% below its own national level, the 31st highest of its 51 states.
Largest premium over the Nevada market: CPT 97110 (Therapeutic exercises) at 223% of market; largest discount: CPT 51728 (Cystometrogram w/vp) at 68%.
In Nevada, BCBS rates come from 37 licensee file sets; the largest is Community Insurance Company (190 sampled providers).
How the four payers compare in Nevada
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 110 | 1 | 48% | 629 | |
| Blue Cross Blue Shield | 105 | 2 | 34% | 277 | |
| Cigna | 100 | 3 | 14% | 657 | |
| Aetna | 87 | 4 | 4% | 615 |
Where Blue Cross Blue Shield pays most and least against the Nevada market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 97110 Therapeutic exercises | $70 | $31 | +123% | 27 |
| 73562 X-ray exam of knee 3 | $84 | $45 | +89% | 26 |
| 73560 X-ray exam of knee 1 or 2 | $71 | $38 | +85% | 26 |
| 72110 X-ray exam l-2 spine 4/>vws | $109 | $59 | +85% | 24 |
| 73630 X-ray exam of foot | $66 | $37 | +80% | 26 |
| 73564 X-ray exam knee 4 or more | $90 | $50 | +79% | 27 |
| 72100 X-ray exam l-s spine 2/3 vws | $79 | $44 | +78% | 26 |
| 73610 X-ray exam of ankle | $70 | $40 | +76% | 26 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 51728 Cystometrogram w/vp | $394 | $581 | -32% | 17 |
| 93925 Lower extremity study | $191 | $273 | -30% | 26 |
| 92004 Compre oph exam new pt 1/> | $80 | $108 | -26% | 64 |
| 99426 Prin care mgmt staff 1st 30 | $63 | $84 | -25% | 16 |
| 51729 Cystometrogram w/vp&up | $417 | $553 | -25% | 17 |
| 77280 Ther rad simulaj field smpl | $204 | $268 | -24% | 18 |
| 52356 Cysto/uretero w/lithotripsy | $546 | $701 | -22% | 20 |
| 76872 Us transrectal | $145 | $180 | -19% | 16 |
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 Nevada
| Licensee file set | Sampled providers |
|---|---|
| Community Insurance Company | 190 |
| HealthKeepers, Inc. | 74 |
| Blue Shield of California Life & Health Insurance Company | 57 |
| BS CA | 54 |
| BCBS TX | 33 |
| Healthy Alliance Life Insurance Company | 23 |
| Matthew Thornton Health Plan, Inc. | 22 |
| Anthem (Elevance) | 20 |
| Regence | 14 |
| Wellmark | 12 |
| BCBS IL | 11 |
| BCBS MI | 9 |
| BCBS NC | 8 |
| Premera | 6 |
| Capital BlueCross | 6 |
| Capital BC | 6 |
| HMO Colorado, Inc. | 6 |
| Excellus BCBS | 5 |
| Carefirst BCBS | 5 |
| BCBS MN | 5 |
| Compcare Health Services Insurance Corporation | 4 |
| BCBS NM | 4 |
| BCBS AZ | 4 |
| BCBS RI | 4 |
| BCBS MT | 3 |
| Blue Cross Blue Shield of Wyoming | 3 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 3 |
| BCBS MA | 3 |
| Blue Cross and Blue Shield of Nebraska | 3 |
| BCBS HI | 2 |
| Horizon Healthcare of New Jersey | 2 |
| BCBS NJ (Horizon) | 2 |
| BCBS KS | 1 |
| Blue Cross Blue Shield of North Dakota | 1 |
| BCBS AL | 1 |
| HMO Missouri, Inc. | 1 |
| BCBS TN | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Nevada?
Blue Cross Blue Shield ranks 2nd of 4 in Nevada with an index of 105. It is highest on 34% of codes.
Are Blue Cross Blue Shield's Nevada rates above or below its national level?
About 6% below.
Which procedure does Blue Cross Blue Shield pay most above market in Nevada?
CPT 97110 (Therapeutic exercises), at 223% of the Nevada 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 Nevada?
Compare your negotiated rates for these codes with Nevada medians for each payer.