Blue Cross Blue Shield negotiated rates in South Dakota
How Blue Cross Blue Shield's South Dakota rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in South Dakota at a glance
What the data shows
Blue Cross Blue Shield ranks 3rd of 4 payers in South Dakota with a rate index of 100 (100 = the South Dakota market median), across 228 procedure codes.
Blue Cross Blue Shield has the highest median for only 20% of codes in South Dakota; UnitedHealthcare leads with an index of 104 in the files analyzed.
Blue Cross Blue Shield's South Dakota rates sit 35% above its own national level, the 6th highest of its 51 states.
Largest premium over the South Dakota market: CPT 93298 (Rem interrog dev eval scrms) at 343% of market; largest discount: CPT 99202 (Office o/p new sf 15 min) at 65%.
In South Dakota, BCBS rates come from 27 licensee file sets; the largest is Wellmark (432 sampled providers).
How the four payers compare in South Dakota
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 104 | 1 | 43% | 316 | |
| Cigna | 103 | 2 | 41% | 286 | |
| Blue Cross Blue Shield | 100 | 3 | 20% | 457 | |
| Aetna | 51 | 4 | 0% | 147 |
Where Blue Cross Blue Shield pays most and least against the South Dakota market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $206 | $60 | +243% | 33 |
| 93297 Rem interrog dev eval icpms | $122 | $56 | +117% | 33 |
| 92235 Fluorescein angrph mltiframe | $352 | $186 | +89% | 38 |
| 92242 Fluorescein&icg angiography | $730 | $438 | +67% | 38 |
| 88313 Special stains group 2 | $183 | $124 | +48% | 25 |
| 93296 Rem interrog evl pm/ids | $63 | $47 | +34% | 33 |
| 88312 Special stains group 1 | $229 | $173 | +32% | 60 |
| 88342 Imhchem/imcytchm 1st antb | $230 | $184 | +25% | 35 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 99202 Office o/p new sf 15 min | $62 | $96 | -35% | 35 |
| 11102 Tangntl bx skin single les | $69 | $90 | -23% | 35 |
| 11302 Shave skin lesion 1.1-2.0 cm | $111 | $144 | -23% | 35 |
| 17313 Mohs 1 stage t/a/l | $591 | $764 | -23% | 35 |
| 17311 Mohs 1 stage h/n/hf/g | $658 | $851 | -23% | 35 |
| 11104 Punch bx skin single lesion | $87 | $112 | -22% | 35 |
| 11301 Shave skin lesion 0.6-1.0 cm | $96 | $123 | -22% | 35 |
| 99457 Rpm tx mgmt 1st 20 min | $48 | $61 | -21% | 155 |
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 Dakota
| Licensee file set | Sampled providers |
|---|---|
| Wellmark | 432 |
| BCBS MN | 190 |
| Blue Cross and Blue Shield of Nebraska | 41 |
| Blue Cross Blue Shield of North Dakota | 32 |
| Community Insurance Company | 24 |
| Healthy Alliance Life Insurance Company | 21 |
| Blue Cross Blue Shield of Wyoming | 16 |
| HealthKeepers, Inc. | 10 |
| BCBS MI | 6 |
| Matthew Thornton Health Plan, Inc. | 5 |
| Anthem (Elevance) | 5 |
| BCBS TX | 5 |
| BCBS KS | 5 |
| BCBS MT | 4 |
| BCBS NC | 3 |
| Regence | 2 |
| BCBS IL | 2 |
| Premera | 1 |
| BCBS NJ (Horizon) | 1 |
| BCBS TN | 1 |
| Carefirst BCBS | 1 |
| BCBS RI | 1 |
| BCBS Kansas City | 1 |
| Horizon Healthcare of New Jersey | 1 |
| BCBS NM | 1 |
| Capital BC | 1 |
| Capital BlueCross | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in South Dakota?
Blue Cross Blue Shield ranks 3rd of 4 in South Dakota with an index of 100. It is highest on 20% of codes.
Are Blue Cross Blue Shield's South Dakota rates above or below its national level?
About 35% above.
Which procedure does Blue Cross Blue Shield pay most above market in South Dakota?
CPT 93298 (Rem interrog dev eval scrms), at 343% of the South Dakota 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 Dakota?
Compare your negotiated rates for these codes with South Dakota medians for each payer.