Blue Cross Blue Shield negotiated rates in South Carolina
How Blue Cross Blue Shield's South Carolina rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in South Carolina at a glance
What the data shows
Blue Cross Blue Shield ranks 1st of 4 payers in South Carolina with a rate index of 116 (100 = the South Carolina market median), across 196 procedure codes.
Blue Cross Blue Shield has the highest median for only 48% of codes in South Carolina; Blue Cross Blue Shield leads with an index of 116 in the files analyzed.
Blue Cross Blue Shield's South Carolina rates sit 5% above its own national level, the 17th highest of its 51 states.
Largest premium over the South Carolina market: CPT 64566 (Neuroeltrd stim post tibial) at 268% of market; largest discount: CPT 93229 (Remote 30 day ecg tech supp) at 62%.
In South Carolina, BCBS rates come from 38 licensee file sets; the largest is BCBS NC (152 sampled providers).
How the four payers compare in South Carolina
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Blue Cross Blue Shield | 116 | 1 | 48% | 311 | |
| UnitedHealthcare | 111 | 2 | 31% | 733 | |
| Cigna | 100 | 3 | 22% | 778 | |
| Aetna | 76 | 4 | 5% | 627 |
Where Blue Cross Blue Shield pays most and least against the South Carolina market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 64566 Neuroeltrd stim post tibial | $193 | $72 | +168% | 33 |
| 11104 Punch bx skin single lesion | $148 | $66 | +125% | 28 |
| 11102 Tangntl bx skin single les | $114 | $53 | +116% | 28 |
| 51702 Insert temp bladder cath | $114 | $53 | +114% | 32 |
| 45388 Colonoscopy w/ablation | $1,037 | $492 | +111% | 48 |
| 43249 Esoph egd dilation <30 mm | $541 | $268 | +102% | 50 |
| 51700 Irrigation of bladder | $131 | $71 | +85% | 33 |
| 52000 Cystourethroscopy | $376 | $207 | +82% | 33 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93229 Remote 30 day ecg tech supp | $634 | $1,016 | -38% | 36 |
| 96910 Photchmtx tar&uvb/ptrltm&uvb | $70 | $106 | -34% | 28 |
| 71271 Ct thorax lung cancer scr c- | $180 | $243 | -26% | 42 |
| 92004 Compre oph exam new pt 1/> | $80 | $107 | -25% | 47 |
| 99350 Home/res vst est high mdm 60 | $195 | $255 | -24% | 22 |
| 99487 Cplx chrnc care 1st 60 min | $95 | $124 | -24% | 22 |
| 71046 X-ray exam chest 2 views | $36 | $45 | -21% | 43 |
| 93458 L hrt artery/ventricle angio | $1,064 | $1,327 | -20% | 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 South Carolina
| Licensee file set | Sampled providers |
|---|---|
| BCBS NC | 152 |
| Community Insurance Company | 122 |
| HealthKeepers, Inc. | 80 |
| Healthy Alliance Life Insurance Company | 22 |
| Matthew Thornton Health Plan, Inc. | 17 |
| BCBS TX | 15 |
| Anthem (Elevance) | 12 |
| BCBS TN | 11 |
| BCBS IL | 10 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 9 |
| BCBS MA | 9 |
| Horizon Healthcare of New Jersey | 8 |
| Compcare Health Services Insurance Corporation | 8 |
| BCBS NJ (Horizon) | 8 |
| BCBS MI | 7 |
| Carefirst BCBS | 6 |
| Wellmark | 6 |
| Blue Shield of California Life & Health Insurance Company | 5 |
| BS CA | 5 |
| BCBS NM | 5 |
| Excellus BCBS | 4 |
| Capital BlueCross | 4 |
| Capital BC | 4 |
| Blue Cross Blue Shield of North Dakota | 4 |
| Blue Cross Blue Shield of Wyoming | 3 |
| Regence | 3 |
| BCBS Kansas City | 3 |
| Premera | 3 |
| HMO Colorado, Inc. | 3 |
| BCBS KS | 2 |
| BCBS MT | 2 |
| BCBS MN | 2 |
| BCBS AL | 1 |
| Blue Cross and Blue Shield of Massachusetts, Inc. | 1 |
| BCBS RI | 1 |
| BCBS HI | 1 |
| Blue Cross and Blue Shield of Nebraska | 1 |
| BCBS OK | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in South Carolina?
Blue Cross Blue Shield ranks 1st of 4 in South Carolina with an index of 116. It is highest on 48% of codes.
Are Blue Cross Blue Shield's South Carolina rates above or below its national level?
About 5% above.
Which procedure does Blue Cross Blue Shield pay most above market in South Carolina?
CPT 64566 (Neuroeltrd stim post tibial), at 268% of the South Carolina 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 South Carolina?
Compare your negotiated rates for these codes with South Carolina medians for each payer.