Blue Cross Blue Shield · Utah · commercial in-network
Blue Cross Blue Shield negotiated rates in Utah
How Blue Cross Blue Shield's Utah rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Utah at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
99
1% below the Utah median
Rank in state
2 of 4
UHC 111 · BCBS 99 · Cigna 94 · Aetna 90
vs own national
97
BCBS's level vs its national median
Codes where highest
22%
of 228 codes
What the data shows
Generated from Utah and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 2nd of 4 payers in Utah with a rate index of 99 (100 = the Utah market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 22% of codes in Utah; UnitedHealthcare leads with an index of 111 in the files analyzed.
3
Blue Cross Blue Shield's Utah rates sit 3% below its own national level, the 26th highest of its 51 states.
4
Largest premium over the Utah market: CPT 96372 (Ther/proph/diag inj sc/im) at 154% of market; largest discount: CPT 51798 (Us urine capacity measure) at 66%.
5
In Utah, BCBS rates come from 38 licensee file sets; the largest is Regence (583 sampled providers).
How the four payers compare in Utah
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 111 | 1 | 48% | 649 | |
| Blue Cross Blue Shield | 99 | 2 | 22% | 667 | |
| Cigna | 94 | 3 | 14% | 751 | |
| Aetna | 90 | 4 | 16% | 418 |
Where Blue Cross Blue Shield pays most and least against the Utah market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 96372 Ther/proph/diag inj sc/im | $35 | $22 | +54% | 86 |
| 36465 Njx noncmpnd sclrsnt 1 vein | $281 | $184 | +53% | 84 |
| 33361 Replace aortic valve perq | $2,929 | $2,074 | +41% | 84 |
| 36482 Endoven ther chem adhes 1st | $416 | $296 | +40% | 84 |
| 75574 Ct angio hrt w/3d image | $812 | $585 | +39% | 81 |
| 33285 Insj subq car rhythm mntr | $191 | $138 | +38% | 84 |
| 78452 Ht muscle image spect mult | $941 | $692 | +36% | 169 |
| 71046 X-ray exam chest 2 views | $56 | $41 | +35% | 101 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 51798 Us urine capacity measure | $16 | $25 | -34% | 63 |
| 45380 Colonoscopy and biopsy | $312 | $465 | -33% | 68 |
| 91110 Gi trc img intral esoph-ile | $839 | $1,213 | -31% | 69 |
| 92136 Ophthalmic biometry | $54 | $74 | -27% | 87 |
| 92250 Fundus photography w/i&r | $42 | $58 | -26% | 88 |
| 99497 Advncd care plan 30 min | $85 | $115 | -26% | 46 |
| 43239 Egd biopsy single/multiple | $214 | $287 | -25% | 69 |
| 43235 Egd diagnostic brush wash | $191 | $255 | -25% | 68 |
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 Utah
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Regence | 583 |
| Community Insurance Company | 89 |
| HealthKeepers, Inc. | 48 |
| Blue Cross Blue Shield of Wyoming | 38 |
| Matthew Thornton Health Plan, Inc. | 22 |
| Healthy Alliance Life Insurance Company | 21 |
| BCBS TX | 20 |
| BCBS MT | 12 |
| BCBS NC | 10 |
| Premera | 8 |
| BCBS AZ | 8 |
| BCBS MN | 8 |
| Anthem (Elevance) | 7 |
| BCBS HI | 6 |
| BS CA | 6 |
| Blue Shield of California Life & Health Insurance Company | 6 |
| Wellmark | 5 |
| BCBS NJ (Horizon) | 4 |
| Carefirst BCBS | 4 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 4 |
| Horizon Healthcare of New Jersey | 4 |
| Compcare Health Services Insurance Corporation | 4 |
| BCBS NM | 4 |
| BCBS MA | 4 |
| HMO Colorado, Inc. | 3 |
| BCBS IL | 3 |
| BCBS TN | 3 |
| BCBS MI | 3 |
| Blue Cross and Blue Shield of Nebraska | 2 |
| HMO Missouri, Inc. | 1 |
| Excellus BCBS | 1 |
| Capital BlueCross | 1 |
| Capital BC | 1 |
| Blue Cross Blue Shield of North Dakota | 1 |
| BCBS Kansas City | 1 |
| Blue Cross and Blue Shield of Massachusetts, Inc. | 1 |
| BCBS KS | 1 |
| BCBS VT | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Utah?
Blue Cross Blue Shield ranks 2nd of 4 in Utah with an index of 99. It is highest on 22% of codes.
Are Blue Cross Blue Shield's Utah rates above or below its national level?
About 3% below.
Which procedure does Blue Cross Blue Shield pay most above market in Utah?
CPT 96372 (Ther/proph/diag inj sc/im), at 154% of the Utah 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 Utah?
Compare your negotiated rates for these codes with Utah medians for each payer.