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Regional Payer (Illinois)Blue Cross Blue Shield (BCBS) family

Payer price transparency data

BCBS Illinois

BCBS Illinois is a regional (Illinois) health insurer, part of the Blue Cross Blue Shield (BCBS) family. They report 82K insurance plans covering 160K providers across 22K billing codes.

Source: public Transparency in Coverage filesRefreshed monthly, latest September 202615 monthly releases tracked

Monthly release

82K

Plans

XX% vs prior month

160K

Providers (NPIs)

XX% vs prior month

36K

Tax IDs

XX% vs prior month

22K

Billing codes

XX% vs prior month

260M

Rate rows

XX% vs prior month

September 2026 release

What's in BCBS Illinois's data

A profile of the machine-readable files BCBS Illinois publishes, after PayerPrice parses and normalizes them.

Billing code types

Distinct codes and rate rows by code system

CodesRows
  • CPT12K220M86%
  • HCPCS7.6K37M14%
  • CDT820160K<0.1%
  • RC44055K<0.1%
  • CSTM-ALL210K<0.1%
  • MS-DRG8302.6K<0.1%
  • LOCAL11.5K<0.1%

Billing class

Professional vs. institutional rate rows

  • Professional250M95%
  • Institutional14M5.5%

Negotiation arrangement

How each rate is expressed

  • Negotiated250M95%
  • Percentage14M5.2%
  • Per Diem45K<0.1%

Plan identifiers

HIOS IDs mark individual and small-group plans; EINs mark employer plans

  • HIOS ID82K100%

Providers by type

Distinct NPIs by entity type

  • Individual (Type 1)130K80%
  • Organization (Type 2)33K20%

Tax IDs by type

How provider groups are identified

  • EIN36K98%
  • NPI (Individual)7001.9%

Top states

States with the most providers in network

  • Illinois130K
  • Indiana5.1K
  • Missouri3.1K
  • Wisconsin2.1K
  • California1.9K
  • Florida1.8K

Top specialties

Provider taxonomies with the most NPIs

  • Clinical Social Worker12K
  • Professional Counselor8.4K
  • Physical Therapist7.4K
  • Family Nurse Practitioner7.1K
  • Family Medicine Physician6.1K
  • Mental Health Counselor5.9K

These are the files. Want the rates inside them?

Look up BCBS Illinois's negotiated rates by provider, TIN, billing code and plan.

Month-over-month history

Track how network size and rate volume change with each monthly release.

MonthPlansNPIsTax IDsBilling codesRate rows
September 202682K160K36K22K260M
June 202683K160K36K22K350M
May 202684K160K36K22K240M
April 2026————
March 2026————

Data quality scorecard

6/6Good

This payer meets all 6 data quality criteria — their transparency files are comprehensive and well-structured.

Evaluated on the September 2026 release.

  • Professional & Institutional Rates

    Data includes both professional and institutional billing class rates

  • Valid Tax IDs

    More than 80% of Tax IDs are EIN or NPI (Organization) type

  • HIOS Plan

    Data includes at least one HIOS-identified plan

  • Low Derived/Percentage Rates

    Less than 10% of negotiation entries are derived or percentage type

  • Standard Code Coverage

    Sufficient CPT and HCPCS code coverage with low proportion of LOCAL entries

  • Common Taxonomies

    NPIs in the dataset cover at least 50 distinct provider taxonomies

How the score works

Each monthly release is checked against six criteria. 5–6 passing criteria rate Good, 3–4 rate Acceptable, and 0–2 rate Poor.

Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.

Access the data

BCBS Illinois's negotiated rates, in the tools your team already uses

PayerPrice turns raw transparency files into one clean, normalized dataset across 180+ payers, refreshed every month. Pick how you want to work with it.

UI

Web app

Search BCBS Illinois's rates by code, provider or market and export the results. No setup required.

Start free trial
API

REST API

Pull negotiated rates, providers and benchmarks into your own products and pipelines.

Explore the API
SQL

Snowflake & Databricks

Query the full normalized dataset with SQL or PySpark, shared directly into your warehouse.

See data sharing
AI

MCP server

Ask Claude, Cursor or your own agents questions like "What does BCBS Illinois pay for CPT 99213 near me?"

Read the MCP docs
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Frequently asked questions

About BCBS Illinois's price transparency data.

What price transparency data does BCBS Illinois publish?

BCBS Illinois's September 2026 Transparency in Coverage files list 82K plans, 160K providers (NPIs), 36K tax IDs and 22K billing codes, for 260M negotiated rate rows in total.

Which states does BCBS Illinois's network cover?

BCBS Illinois's files include providers in 51 states. The states with the most in-network providers are Illinois, Indiana, Missouri, Wisconsin, California.

How often is BCBS Illinois's data updated?

Payers must post updated machine-readable files every month. PayerPrice processes BCBS Illinois's files monthly; the latest processed release is September 2026, and 15 monthly releases are available.

What is the Transparency in Coverage rule?

Since July 2022, the federal Transparency in Coverage rule has required most group health plans and health insurers to publish machine-readable files of their in-network negotiated rates and out-of-network allowed amounts, updated monthly. These files are the source for the data on this page.

How can I access BCBS Illinois's negotiated rates?

Start a free PayerPrice trial to search BCBS Illinois's rates in the web app, or book a demo to get the full dataset through the REST API, SQL in Snowflake or Databricks, or AI assistants through the PayerPrice MCP server.