Blue Cross Blue Shield · North Dakota · commercial in-network
Blue Cross Blue Shield negotiated rates in North Dakota
How Blue Cross Blue Shield's North Dakota rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in North Dakota at a glance
Across 226 procedure codes for 8 specialties
Rate index vs state market
111
11% above the North Dakota median
Rank in state
1 of 4
BCBS 111 · UHC 102 · Cigna 81 · Aetna 54
vs own national
148
BCBS's level vs its national median
Codes where highest
68%
of 226 codes
What the data shows
Generated from North Dakota and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 1st of 4 payers in North Dakota with a rate index of 111 (100 = the North Dakota market median), across 226 procedure codes.
2
Blue Cross Blue Shield has the highest median for 68% of codes in North Dakota.
3
Blue Cross Blue Shield's North Dakota rates sit 48% above its own national level, the 4th highest of its 51 states.
4
Largest premium over the North Dakota market: CPT 93298 (Rem interrog dev eval scrms) at 211% of market; largest discount: CPT 52332 (Cystoscopy and treatment) at 100%.
5
In North Dakota, BCBS rates come from 36 licensee file sets; the largest is Blue Cross Blue Shield of North Dakota (282 sampled providers).
How the four payers compare in North Dakota
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Blue Cross Blue Shield | 111 | 1 | 68% | 329 | |
| UnitedHealthcare | 102 | 2 | 28% | 210 | |
| Cigna | 81 | 3 | 14% | 71 | |
| Aetna | 54 | 4 | 0% | 211 |
Where Blue Cross Blue Shield pays most and least against the North Dakota market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $221 | $105 | +111% | 28 |
| 99212 Office o/p est sf 10 min | $125 | $63 | +99% | 237 |
| 99213 Office o/p est low 20 min | $202 | $107 | +89% | 237 |
| 93297 Rem interrog dev eval icpms | $134 | $72 | +86% | 28 |
| 99214 Office o/p est mod 30 min | $284 | $156 | +83% | 237 |
| 76872 Us transrectal | $381 | $215 | +77% | 19 |
| 99202 Office o/p new sf 15 min | $149 | $88 | +70% | 15 |
| 99204 Office o/p new mod 45 min | $371 | $233 | +59% | 239 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 52332 Cystoscopy and treatment | $455 | $455 | +0% | 18 |
| 52648 Laser surgery of prostate | $1,799 | $1,799 | +0% | 18 |
| 64566 Neuroeltrd stim post tibial | $74 | $74 | +0% | 18 |
| 52000 Cystourethroscopy | $234 | $234 | +0% | 18 |
| 51702 Insert temp bladder cath | $73 | $73 | +0% | 18 |
| 51700 Irrigation of bladder | $87 | $87 | +0% | 18 |
| 52224 Cystoscopy and treatment | $505 | $505 | +0% | 18 |
| 65778 Cover eye w/membrane | $84 | $84 | +0% | 31 |
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 North Dakota
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Blue Cross Blue Shield of North Dakota | 282 |
| BCBS MN | 184 |
| Community Insurance Company | 30 |
| Wellmark | 23 |
| Healthy Alliance Life Insurance Company | 21 |
| BCBS TX | 12 |
| Regence | 8 |
| Anthem (Elevance) | 8 |
| HealthKeepers, Inc. | 8 |
| BCBS IL | 8 |
| BCBS KS | 7 |
| Blue Shield of California Life & Health Insurance Company | 7 |
| BCBS NC | 7 |
| BS CA | 7 |
| Matthew Thornton Health Plan, Inc. | 7 |
| Excellus BCBS | 6 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 5 |
| BCBS OK | 4 |
| Blue Cross and Blue Shield of Nebraska | 4 |
| BCBS MI | 4 |
| BCBS MA | 4 |
| Carefirst BCBS | 3 |
| BCBS NM | 3 |
| BCBS NJ (Horizon) | 3 |
| Compcare Health Services Insurance Corporation | 3 |
| Blue Cross Blue Shield of Wyoming | 3 |
| Horizon Healthcare of New Jersey | 3 |
| Premera | 3 |
| BCBS TN | 2 |
| BCBS Kansas City | 2 |
| BCBS MT | 2 |
| Capital BC | 1 |
| BCBS AZ | 1 |
| BCBS RI | 1 |
| Capital BlueCross | 1 |
| HMO Missouri, Inc. | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in North Dakota?
Blue Cross Blue Shield ranks 1st of 4 in North Dakota with an index of 111. It is highest on 68% of codes.
Are Blue Cross Blue Shield's North Dakota rates above or below its national level?
About 48% above.
Which procedure does Blue Cross Blue Shield pay most above market in North Dakota?
CPT 93298 (Rem interrog dev eval scrms), at 211% of the North Dakota 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 North Dakota?
Compare your negotiated rates for these codes with North Dakota medians for each payer.