Blue Cross Blue Shield · Washington · commercial in-network
Blue Cross Blue Shield negotiated rates in Washington
How Blue Cross Blue Shield's Washington rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Washington at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
98
2% below the Washington median
Rank in state
3 of 4
UHC 106 · Cigna 99 · BCBS 98 · Aetna 91
vs own national
132
BCBS's level vs its national median
Codes where highest
8%
of 228 codes
What the data shows
Generated from Washington and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 3rd of 4 payers in Washington with a rate index of 98 (100 = the Washington market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 8% of codes in Washington; UnitedHealthcare leads with an index of 106 in the files analyzed.
3
Blue Cross Blue Shield's Washington rates sit 32% above its own national level, the 7th highest of its 51 states.
4
Largest premium over the Washington market: CPT 88313 (Special stains group 2) at 163% of market; largest discount: CPT 92136 (Ophthalmic biometry) at 82%.
5
In Washington, BCBS rates come from 37 licensee file sets; the largest is Premera (716 sampled providers).
How the four payers compare in Washington
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 106 | 1 | 60% | 695 | |
| Cigna | 99 | 2 | 13% | 749 | |
| Blue Cross Blue Shield | 98 | 3 | 8% | 799 | |
| Aetna | 91 | 4 | 19% | 708 |
Where Blue Cross Blue Shield pays most and least against the Washington market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 88313 Special stains group 2 | $162 | $99 | +63% | 89 |
| 88305 Tissue exam by pathologist | $137 | $86 | +60% | 188 |
| 88312 Special stains group 1 | $199 | $136 | +46% | 188 |
| 92235 Fluorescein angrph mltiframe | $223 | $170 | +31% | 108 |
| 52000 Cystourethroscopy | $319 | $252 | +27% | 102 |
| 93298 Rem interrog dev eval scrms | $91 | $72 | +27% | 103 |
| 43255 Egd control bleeding any | $714 | $565 | +26% | 89 |
| 76872 Us transrectal | $367 | $295 | +24% | 105 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 92136 Ophthalmic biometry | $67 | $83 | -18% | 108 |
| 92250 Fundus photography w/i&r | $51 | $62 | -18% | 106 |
| 72125 Ct neck spine w/o dye | $263 | $307 | -14% | 100 |
| 72141 Mri neck spine w/o dye | $387 | $451 | -14% | 100 |
| 70551 Mri brain stem w/o dye | $419 | $484 | -14% | 100 |
| 72158 Mri lumbar spine w/o & w/dye | $641 | $734 | -13% | 100 |
| 70450 Ct head/brain w/o dye | $214 | $245 | -12% | 100 |
| 90960 Esrd srv 4 visits p mo 20+ | $654 | $742 | -12% | 100 |
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 Washington
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Premera | 716 |
| Regence | 535 |
| Community Insurance Company | 96 |
| HealthKeepers, Inc. | 31 |
| BCBS TX | 26 |
| BCBS MT | 21 |
| Blue Shield of California Life & Health Insurance Company | 18 |
| Healthy Alliance Life Insurance Company | 18 |
| BS CA | 18 |
| BCBS IL | 12 |
| Matthew Thornton Health Plan, Inc. | 11 |
| Anthem (Elevance) | 11 |
| BCBS MI | 10 |
| BCBS MN | 10 |
| BCBS NC | 9 |
| Wellmark | 7 |
| BCBS HI | 6 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 6 |
| BCBS MA | 5 |
| BCBS NM | 5 |
| BCBS TN | 5 |
| Compcare Health Services Insurance Corporation | 5 |
| Carefirst BCBS | 4 |
| BCBS RI | 3 |
| Blue Cross Blue Shield of North Dakota | 3 |
| Capital BC | 3 |
| Capital BlueCross | 3 |
| BCBS AZ | 2 |
| BCBS OK | 2 |
| Horizon Healthcare of New Jersey | 2 |
| BCBS NJ (Horizon) | 2 |
| Blue Cross Blue Shield of Wyoming | 2 |
| Blue Cross and Blue Shield of Massachusetts, Inc. | 1 |
| Excellus BCBS | 1 |
| Blue Cross and Blue Shield of Nebraska | 1 |
| BCBS VT | 1 |
| HMO Colorado, Inc. | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Washington?
Blue Cross Blue Shield ranks 3rd of 4 in Washington with an index of 98. It is highest on 8% of codes.
Are Blue Cross Blue Shield's Washington rates above or below its national level?
About 32% above.
Which procedure does Blue Cross Blue Shield pay most above market in Washington?
CPT 88313 (Special stains group 2), at 163% of the Washington 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 Washington?
Compare your negotiated rates for these codes with Washington medians for each payer.