Blue Cross Blue Shield · Tennessee · commercial in-network
Blue Cross Blue Shield negotiated rates in Tennessee
How Blue Cross Blue Shield's Tennessee rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Tennessee at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
103
3% above the Tennessee median
Rank in state
2 of 4
UHC 112 · BCBS 103 · Cigna 97 · Aetna 82
vs own national
102
BCBS's level vs its national median
Codes where highest
18%
of 228 codes
What the data shows
Generated from Tennessee and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 2nd of 4 payers in Tennessee with a rate index of 103 (100 = the Tennessee market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 18% of codes in Tennessee; UnitedHealthcare leads with an index of 112 in the files analyzed.
3
Blue Cross Blue Shield's Tennessee rates sit 2% above its own national level, the 22nd highest of its 51 states.
4
Largest premium over the Tennessee market: CPT 76512 (Oph us dx b-scan) at 158% of market; largest discount: CPT 88305 (Tissue exam by pathologist) at 70%.
5
In Tennessee, BCBS rates come from 37 licensee file sets; the largest is BCBS TN (759 sampled providers).
How the four payers compare in Tennessee
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 112 | 1 | 58% | 775 | |
| Blue Cross Blue Shield | 103 | 2 | 18% | 844 | |
| Cigna | 97 | 3 | 16% | 850 | |
| Aetna | 82 | 4 | 8% | 767 |
Where Blue Cross Blue Shield pays most and least against the Tennessee market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 76512 Oph us dx b-scan | $92 | $58 | +58% | 110 |
| 92250 Fundus photography w/i&r | $69 | $47 | +45% | 110 |
| 92136 Ophthalmic biometry | $90 | $64 | +42% | 110 |
| 97110 Therapeutic exercises | $40 | $33 | +22% | 88 |
| 99490 Chrnc care mgmt staff 1st 20 | $70 | $58 | +21% | 407 |
| 75574 Ct angio hrt w/3d image | $550 | $461 | +19% | 109 |
| 73610 X-ray exam of ankle | $56 | $47 | +19% | 84 |
| 99487 Cplx chrnc care 1st 60 min | $135 | $114 | +18% | 95 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 88305 Tissue exam by pathologist | $34 | $49 | -30% | 213 |
| 88313 Special stains group 2 | $39 | $55 | -29% | 96 |
| 88312 Special stains group 1 | $53 | $64 | -17% | 213 |
| 99202 Office o/p new sf 15 min | $56 | $67 | -16% | 117 |
| 55866 Laps surg prst8ect rpbic rad | $1,763 | $2,100 | -16% | 101 |
| 52224 Cystoscopy and treatment | $353 | $411 | -14% | 101 |
| 93656 Compre ep eval abltj atr fib | $1,373 | $1,583 | -13% | 113 |
| 92235 Fluorescein angrph mltiframe | $106 | $122 | -13% | 110 |
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 Tennessee
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| BCBS TN | 759 |
| Community Insurance Company | 173 |
| HealthKeepers, Inc. | 112 |
| Anthem (Elevance) | 57 |
| BCBS MS | 54 |
| BCBS NC | 40 |
| Healthy Alliance Life Insurance Company | 31 |
| BCBS TX | 27 |
| Matthew Thornton Health Plan, Inc. | 14 |
| BCBS IL | 10 |
| BCBS MN | 10 |
| BCBS OK | 8 |
| Horizon Healthcare of New Jersey | 6 |
| BCBS NJ (Horizon) | 6 |
| Blue Cross Blue Shield of North Dakota | 5 |
| BCBS NM | 5 |
| BS CA | 5 |
| HMO Colorado, Inc. | 5 |
| Blue Shield of California Life & Health Insurance Company | 5 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 5 |
| BCBS MA | 5 |
| BCBS AL | 4 |
| Capital BlueCross | 4 |
| BCBS Kansas City | 4 |
| Capital BC | 4 |
| Wellmark | 4 |
| Compcare Health Services Insurance Corporation | 3 |
| Carefirst BCBS | 3 |
| BCBS HI | 3 |
| Blue Cross Blue Shield of Wyoming | 3 |
| Regence | 3 |
| BCBS MI | 2 |
| BCBS MT | 2 |
| BCBS KS | 2 |
| Premera | 2 |
| BCBS AZ | 1 |
| HMO Missouri, Inc. | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Tennessee?
Blue Cross Blue Shield ranks 2nd of 4 in Tennessee with an index of 103. It is highest on 18% of codes.
Are Blue Cross Blue Shield's Tennessee rates above or below its national level?
About 2% above.
Which procedure does Blue Cross Blue Shield pay most above market in Tennessee?
CPT 76512 (Oph us dx b-scan), at 158% of the Tennessee 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 Tennessee?
Compare your negotiated rates for these codes with Tennessee medians for each payer.