Blue Cross Blue Shield · Oregon · commercial in-network
Blue Cross Blue Shield negotiated rates in Oregon
How Blue Cross Blue Shield's Oregon rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Oregon at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
90
10% below the Oregon median
Rank in state
3 of 4
UHC 121 · Cigna 100 · BCBS 90 · Aetna 71
vs own national
124
BCBS's level vs its national median
Codes where highest
7%
of 228 codes
What the data shows
Generated from Oregon and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 3rd of 4 payers in Oregon with a rate index of 90 (100 = the Oregon market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 7% of codes in Oregon; UnitedHealthcare leads with an index of 121 in the files analyzed.
3
Blue Cross Blue Shield's Oregon rates sit 24% above its own national level, the 11th highest of its 51 states.
4
Largest premium over the Oregon market: CPT 88313 (Special stains group 2) at 259% of market; largest discount: CPT 93298 (Rem interrog dev eval scrms) at 40%.
5
In Oregon, BCBS rates come from 35 licensee file sets; the largest is Regence (184 sampled providers).
How the four payers compare in Oregon
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 121 | 1 | 78% | 683 | |
| Cigna | 100 | 2 | 10% | 735 | |
| Blue Cross Blue Shield | 90 | 3 | 7% | 351 | |
| Aetna | 71 | 4 | 5% | 494 |
Where Blue Cross Blue Shield pays most and least against the Oregon market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 88313 Special stains group 2 | $281 | $109 | +159% | 67 |
| 43248 Egd guide wire insertion | $1,432 | $653 | +120% | 67 |
| 43251 Egd remove lesion snare | $1,719 | $800 | +115% | 68 |
| 88312 Special stains group 1 | $276 | $147 | +88% | 113 |
| 88342 Imhchem/imcytchm 1st antb | $190 | $108 | +76% | 46 |
| 88305 Tissue exam by pathologist | $177 | $118 | +50% | 113 |
| 45380 Colonoscopy and biopsy | $1,502 | $1,159 | +30% | 67 |
| 43235 Egd diagnostic brush wash | $998 | $772 | +29% | 67 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $69 | $174 | -60% | 34 |
| 92004 Compre oph exam new pt 1/> | $85 | $195 | -56% | 54 |
| 92014 Compre oph exam est pt 1/> | $85 | $164 | -48% | 51 |
| 92242 Fluorescein&icg angiography | $385 | $603 | -36% | 36 |
| 93297 Rem interrog dev eval icpms | $65 | $102 | -36% | 33 |
| 93312 Echo transesophageal | $339 | $527 | -36% | 32 |
| 99454 Rem mntr physiol param 16-30 | $76 | $118 | -35% | 60 |
| 75574 Ct angio hrt w/3d image | $464 | $705 | -34% | 32 |
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 Oregon
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Regence | 184 |
| Community Insurance Company | 96 |
| Premera | 52 |
| HealthKeepers, Inc. | 42 |
| BCBS TX | 28 |
| Blue Shield of California Life & Health Insurance Company | 26 |
| BS CA | 26 |
| Healthy Alliance Life Insurance Company | 20 |
| BCBS NC | 15 |
| Anthem (Elevance) | 14 |
| Wellmark | 12 |
| Matthew Thornton Health Plan, Inc. | 12 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 12 |
| BCBS MA | 12 |
| BCBS IL | 8 |
| BCBS RI | 7 |
| BCBS MT | 7 |
| BCBS NM | 5 |
| Compcare Health Services Insurance Corporation | 5 |
| Blue Cross Blue Shield of Wyoming | 5 |
| Excellus BCBS | 5 |
| BCBS MN | 5 |
| HMO Colorado, Inc. | 3 |
| BCBS OK | 3 |
| BCBS HI | 3 |
| BCBS TN | 3 |
| BCBS KS | 3 |
| Blue Cross and Blue Shield of Nebraska | 2 |
| Carefirst BCBS | 2 |
| BCBS MI | 2 |
| BCBS AZ | 2 |
| Capital BlueCross | 1 |
| Capital BC | 1 |
| Blue Cross Blue Shield of North Dakota | 1 |
| BCBS Kansas City | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Oregon?
Blue Cross Blue Shield ranks 3rd of 4 in Oregon with an index of 90. It is highest on 7% of codes.
Are Blue Cross Blue Shield's Oregon rates above or below its national level?
About 24% above.
Which procedure does Blue Cross Blue Shield pay most above market in Oregon?
CPT 88313 (Special stains group 2), at 259% of the Oregon 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 Oregon?
Compare your negotiated rates for these codes with Oregon medians for each payer.