MyBlue Health HMO
HMO
TX
Network Quality History
August 2025
- Codes
- 16K
Number of unique codes
- Rows
- 54M 2%
Rows of data in the file
- Prices
- 448M 1%
Count of prices after exploding NPIs
- NPIs
- 12K
Number of unique NPIs
- EINs
- 12K
Number of unique EINs
Pro Fees
Data includes professional fees for common CPT / HCPCS codes sampled
Institutional Fees
Data includes institutional fees for common *-DRG / CPT / HCPCS codes sampled
Common Codes
Data includes fees across most or all highest utilized codes (e.g., 470, 27447, 99203, 90837)
Common Taxonomies
NPIs included in the dataset cover all common taxonomies (e.g., Family Medicine, LCSW, Dermatologist, Physical Therapist, ASC, Hospital)
Priced Providers
Adequate number of providers have prices in the dataset (based on network region and size)
Low Ambiguous Rates
Data does not have significant instances of multiple rates posted for the same ein/npi list, service, and billing details
CMS Within Threshold
Rates included in the data are generally within reasonable CMS baseline limits
- Methodology
In order to determine the overall status for a payer network posting for a given month, the above tests are applied and evaluated.
- If all tests pass, status is green.
- If 1 test fails, status turns yellow.
- If 2 or more tests fail, status turns red.
192 Available Payers
- Aetna
- Allegiance
- Alliant Health Plans
- Allina Health
- AllWays Health Partners
- Ambetter
- Americas PPO
- AmeriHealth Insurance Company of New Jersey
- Anthem
- Arkansas Blue Cross and Blue Shield
- Aspirus Health Plan
- Asuris Northwest Health
- AultCare Insurance Company
- Avera Health Plans Inc
- AvMed
- Baylor Scott and White Health Plan
- BCBS Puerto Rico (Triple S)
- Beacon Health Options
- Blue Card
- Blue Cross and Blue Shield of Illinois
- Blue Cross and Blue Shield of Kansas
- Blue Cross and Blue Shield of Kansas City
- Blue Cross and Blue Shield of Montana
- Blue Cross and Blue Shield of Nebraska
- Blue Cross and Blue Shield of New Mexico
- Blue Cross and Blue Shield of North Carolina
- Blue Cross and Blue Shield of Oklahoma
- Blue Cross and Blue Shield of Texas
- Blue Cross and Blue Shield of Vermont
- Blue Cross and Blue Shield of Wyoming
- Blue Cross Blue Shield Louisiana
- Blue Cross Blue Shield of Alabama
- Blue Cross Blue Shield of Arizona
- Blue Cross Blue Shield of Massachusetts
- Blue Cross Blue Shield of Michigan
- Blue Cross Blue Shield of Minnesota
- Blue Cross Blue Shield of Mississippi
- Blue Cross Blue Shield of North Dakota
- Blue Cross Blue Shield of Rhode Island
- Blue Cross of Idaho
- Blue Shield of California
- BlueCross BlueShield of South Carolina
- BlueCross BlueShield of Tennessee
- BridgeSpan
- Capital BlueCross
- Capital District Physicians Health Plan
- Capital Health Plan Inc
- CareFirst BlueCross BlueShield
- Caresource
- CenterCare
- Centivo
- Central California Alliance for Health
- Christus
- Cigna Corporation
- Common Ground Healthcare Cooperative
- Community Health Choice
- Community Health Options
- Community Health Plan of Washington
- CommunityCare
- ComPsych
- Connecticare
- Contra Costa Health
- Cox Health Systems
- Curative
- Dean Health Plan
- Denver Health Medical Plan
- EHN
- Emblem Health
- EMI Health
- Encore
- Evolutions Healthcare Systems
- Excellus BlueCross BlueShield
- Fallon Health
- Fidelis Care
- First Choice Health
- First Health
- Florida Blue
- Geisinger Health Plan
- GlobalHealth
- Group Health Cooperative of Eau Claire
- Group Health Cooperative of South Central Wisconsin
- HAP
- Harvard Pilgrim Healthcare
- Hawaii Medical Service Association
- Health Advantage HMO Partners
- Health Alliance
- Health First
- Health Net
- Health New England Inc
- Health Plan of Nevada
- Health2Business
- Healthcare Highways
- Healthchoice
- Healthfirst
- HealthLink
- HealthPartners
- Healthsmart
- Henry Ford Health System
- Highmark Blue Cross Blue Shield Delaware
- Highmark Blue Cross Blue Shield Pennsylvania
- Highmark Blue Cross Blue Shield West Virginia
- Highmark Blue Cross Blue Shield Western New York
- Highmark Blue Shield of Northeastern New York
- Highmark Blue Shield Pennsylvania
- HMA
- Hometown Health Plan
- Horizon Blue Cross Blue Shield of New Jersey
- Humana
- Imagine360
- Independence BCBS
- Independent Health
- Innovation Health Plan
- IU Health Plans
- Jefferson Health Plans
- Johns Hopkins Health Plans
- Kaiser Foundation Health Plan
- Lifewise
- Magellan Health
- MagnaCare
- McLaren
- Medcost
- Medica
- Medical Associates Health Plan
- Medical Card System Puerto Rico
- Medical Mutual of Ohio
- MercyCare
- Meritain Health
- MHN
- Midlands Choice
- Moda Health
- Molina Healthcare
- Mountain Health COOP
- MultiPlan
- MVP Health Care
- Neighborhood Health Plan of Rhode Island
- Network Health
- Ohio PPO Connect
- Optum
- Oscar Insurance Corporation
- Oxford Health Plan
- Pacificare
- PacificSource Health Plans
- Paramount Insurance Company
- Physicians Health Plan
- Physicians Health Plan of Northern Indiana
- Piedmont Health Plan
- Preferred Health Professionals
- Premera Blue Cross
- Presbyterian Health Plan
- Prime Health Services
- Priority Health
- Providence Health Plan
- ProviDRs Care
- Qualchoice
- Quartz
- Regence BlueCross BlueShield of Oregon
- Regence BlueCross BlueShield of Utah
- Regence BlueShield of Idaho
- Regence BlueShield of Washington
- Rocky Mountain Health Plan
- Sagamore Health Network
- Samaritan Health Plans
- Sana Benefits
- Sanford Health Group
- Security Health Plan of Wisconsin
- SelectHealth
- Sentara Health Plans
- Sierra Health and Life
- SmartHealth
- Summa Care
- Sutter Health Plus
- The Alliance
- The Health Plan
- Trilogy
- Truli
- Tufts Health Plan
- UCare
- UHA
- UnitedHealthcare
- Univera Healthcare
- University of Utah Health Plans
- UPMC Health Plan
- Valley Health Plan
- Viva Health
- Wellmark Blue Cross and Blue Shield of Iowa
- Wellmark Blue Cross and Blue Shield of South Dakota
- Wellpoint
- WellSense Health Plan
- Western Health Advantage
- WPS Health Plan
- Yale University Health Plan
- Zelis
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