57 payers, ranked by contracted index. Index is the median contracted rate relative to Medicare ASP = 100.
Brand and Biosimilar split that median by product type — a biosimilar index well above the brand index means the payer pays a premium for the cheaper product. Contract variability is how many distinct rates a payer runs for the same drug across practices: Low is close to a single fee schedule, High means rates are negotiated practice by practice. Drugs observed and States size the filing behind each row. Contracted rates come from insurers’ machine-readable files — not amounts paid on a claim.
| Payer | Grade | Index | Vs. acquisition | Brand | Biosimilar | Contract variability | Drugs observed | States |
|---|---|---|---|---|---|---|---|---|
| BlueCross BlueShield of Illinois | A | 166.1 | +61.7% | 166.0 | 170.7 | High | 713 | 8 |
| Anthem Colorado | A | 132.5 | +29.0% | 131.6 | 154.8 | Medium | 890 | 8 |
| BlueCross BlueShield of Wyoming | A | 132.3 | +28.8% | 130.8 | 210.1 | Low | 911 | 7 |
| BlueCross BlueShield of South Carolina | A | 124.7 | +21.5% | 124.1 | 196.1 | Low | 869 | 6 |
| HMSA (BCBS Hawaii) | A | 124.1 | +20.8% | 123.3 | 141.9 | Low | 874 | 5 |
| Regence Idaho | A | 118.4 | +15.3% | 118.5 | 118.2 | Low | 714 | 6 |
| Premera Blue Cross | A | 114.9 | +11.9% | 114.0 | 156.4 | Low | 897 | 9 |
| BlueCross BlueShield of Nebraska | A | 113.2 | +10.2% | 113.2 | 121.8 | Low | 932 | 7 |
| BlueCross BlueShield of Texas | A | 113.2 | +10.2% | 113.2 | 132.2 | Low | 781 | 28 |
| BlueCross BlueShield of Oklahoma | A | 112.4 | +9.4% | 112.1 | 167.0 | High | 630 | 3 |
| Regence Utah | A | 109.7 | +6.8% | 109.7 | 111.8 | Low | 710 | 5 |
| Blue KC (Kansas City) | A | 109.6 | +6.7% | 109.6 | 109.9 | Medium | 758 | 2 |
| BlueCross BlueShield of Arkansas | A | 108.5 | +5.6% | 108.5 | 133.4 | Low | 917 | 21 |
| Blue Shield of California | A | 108.1 | +5.3% | 107.7 | 114.4 | Medium | 850 | 4 |
| BlueCross BlueShield of Kansas | A | 108.1 | +5.3% | 108.1 | 117.4 | Low | 847 | 6 |
| BCBS North Dakota | A | 107.3 | +4.4% | 107.3 | 107.0 | High | 909 | 3 |
| Blue Cross of Idaho | A | 107.1 | +4.3% | 106.9 | 113.7 | Medium | 928 | 6 |
| BlueCross BlueShield of Louisiana | A | 107.0 | +4.2% | 107.0 | 109.5 | Low | 900 | 7 |
| Blue Cross NC | A | 105.7 | +2.9% | 105.6 | 121.8 | Medium | 844 | 52 |
| Kaiser Permanente | A | 105.4 | +2.7% | 105.0 | 117.3 | High | 937 | 8 |
| Regence BlueCross BlueShield | A | 105.0 | +2.2% | 104.9 | 105.7 | Medium | 718 | 15 |
| Excellus BCBS | B+ | 103.7 | +1.0% | 103.6 | 122.2 | Low | 915 | 1 |
| Aetna | B | 103.2 | +0.4% | 103.0 | 112.8 | Medium | 920 | 51 |
| Anthem Massachusetts | B | 102.9 | +0.2% | 102.9 | 103.8 | Low | 851 | 25 |
| Anthem Wisconsin | B | 102.8 | +0.1% | 102.6 | 109.3 | Medium | 884 | 14 |
| Capital Blue Cross | B | 102.7 | -0.0% | 102.7 | 103.6 | Low | 924 | 35 |
| Regence Washington | C+ | 101.5 | -1.2% | 101.4 | 106.9 | Low | 699 | 5 |
| BlueCross BlueShield of Vermont | C+ | 101.1 | -1.6% | 101.3 | 97.3 | Low | 158 | 1 |
| Anthem California | C+ | 100.6 | -2.0% | 100.5 | 113.6 | Medium | 927 | 5 |
| Anthem New Hampshire | C | 100.2 | -2.5% | 100.1 | 107.8 | Low | 852 | 14 |
| Centene | C | 100.1 | -2.6% | 100.1 | 101.4 | Medium | 333 | 41 |
| Anthem Indiana | C | 100.1 | -2.6% | 100.0 | 109.3 | Medium | 942 | 29 |
| Anthem Missouri | C | 100.0 | -2.6% | 100.0 | 102.6 | Medium | 871 | 16 |
| Horizon BCBS of New Jersey | C | 100.0 | -2.6% | 100.0 | 102.6 | Medium | 936 | 6 |
| Wellmark BCBS (Iowa/South Dakota) | C | 100.0 | -2.6% | 100.0 | 113.6 | Low | 908 | 10 |
| Cigna | C | 100.0 | -2.6% | 100.0 | 107.8 | Medium | 945 | 52 |
| Anthem Kentucky | C | 100.0 | -2.6% | 100.0 | 100.0 | Medium | 929 | 17 |
| UnitedHealthcare | C | 100.0 | -2.6% | 100.0 | 104.3 | High | 945 | 52 |
| Anthem New York | C | 100.0 | -2.6% | 100.0 | 102.5 | Low | 927 | 15 |
| Anthem Ohio | C | 100.0 | -2.6% | 100.0 | 102.5 | Medium | 940 | 19 |
| BlueCross BlueShield of Tennessee | C | 100.0 | -2.6% | 100.0 | 108.5 | Low | 869 | 10 |
| Harvard Pilgrim Health Care | C | 100.0 | -2.6% | 100.0 | 100.3 | Low | 917 | 10 |
| BlueCross BlueShield of Alabama | C | 99.9 | -2.7% | 99.9 | 102.5 | Low | 742 | 6 |
| Anthem Georgia | C | 99.9 | -2.8% | 99.9 | 100.9 | Medium | 923 | 20 |
| CareFirst BlueCross BlueShield | C | 99.9 | -2.8% | 99.8 | 104.2 | Low | 880 | 19 |
| Regence Oregon | C | 99.9 | -2.8% | 99.8 | 102.5 | Low | 705 | 7 |
| BlueCross BlueShield of Minnesota | C | 99.8 | -2.8% | 99.8 | 100.3 | High | 925 | 9 |
| Anthem Virginia | C | 99.7 | -2.9% | 99.7 | 101.4 | Low | 922 | 22 |
| Florida Blue | C | 99.7 | -2.9% | 99.6 | 101.7 | Low | 839 | 5 |
| Anthem Connecticut | C | 99.7 | -3.0% | 99.6 | 104.3 | Low | 924 | 5 |
| Anthem Nevada | C | 99.7 | -3.0% | 99.6 | 101.7 | Low | 860 | 4 |
| BlueCross BlueShield of Massachusetts | D | 99.5 | -3.1% | 99.6 | 96.9 | High | 795 | 13 |
| BlueCross BlueShield of Rhode Island | D | 99.1 | -3.5% | 99.0 | 101.7 | Low | 778 | 3 |
| Anthem Maine | D | 98.4 | -4.2% | 98.3 | 102.7 | Medium | 824 | 13 |
| BlueCross BlueShield of Mississippi | D | 96.2 | -6.3% | 96.2 | 108.4 | Low | 773 | 4 |
| BlueCross BlueShield of Michigan | D | 95.3 | -7.2% | 95.2 | 101.1 | Medium | 644 | 17 |
| BlueCross BlueShield of Arizona | D | 83.0 | -19.2% | 83.0 | 84.2 | Medium | 883 | 19 |
Benchmarks: typical acquisition 102.7 · Medicare 104.3 after sequestration · 106 statutory (ASP = 100).