BCBS Texas — Negotiated Price Transparency

Transparency-in-Coverage machine-readable files (in-network negotiated rates + prescription drugs) published by Blue Cross and Blue Shield of Texas (HCSC).

Source: https://www.bcbstx.com/member/machine-readable-files · Cadence: monthly refresh (source files restated ~monthly)

Start here

New to this project? Read the full how-to first: BCBS Texas Price Transparency Guide (PDF). It explains where the data comes from, the unit of analysis, every inclusion decision, and how to analyze the data in Stata.

Unit of analysis: one row of bcbstx_prices.dta = one DISTINCT negotiated price for a procedure in a network, with provider COUNTS (not volume).
Scope: BCBS Texas, both coverage segments, Texas providers (NPPES practice state = TX), a 93-code policy-team menu, plus a separate prescription-drug table.
Key limits: no claims/volume, no Medicare benchmark, no sub-state geography yet — see the feasibility matrix in 600.

The pipeline (each page is a Stata do-file)

100 Download — Python pulls + filters the MRFs into 01_raw/_extracted/ (guarded; won't re-pull on a rebuild)
200 Management — import CSVs, attach the service menu, build the analytic .dta
300 Labels — plain-English variable + value labels
400 Profiler — coverage, data-quality, descriptive profiling (multi-snapshot ready)
500 Aggregation — price-summary tables (median, dispersion) per service
600 Analysis — price-variation analyses, shoppable case studies, feasibility matrix, expansion menu
Help — how this archive + webdoc2 work

Reference documents

Inventory snapshot

Auto-generated at build time from /Users/ericbooth/Library/CloudStorage/GoogleDrive-eric.booth@texas2036.org/Shared drives/Data and Research Team/_datashare/Insurance_PriceTransparency/BCBSTX.

. di as txt "02_cleaned/  (analytic .dta)"
02_cleaned/  (analytic .dta)

. local clfiles : dir "${clean}" files "*.dta"

. foreach f of local clfiles {
  2.     use "${clean}/`f'", clear
  3.     di as txt "  - `f'  (rows=`=_N'  vars=`=c(k)')"
  4. }
(BCBS Texas prescription-drug negotiated prices (1 row = 1 distinct NDC price).)
  - bcbstx_rx_prices.dta  (rows=1198555  vars=17)
(BCBSTX price summary by procedure x provider type x network x snapshot)
  - bcbstx_price_summary_by_network.dta  (rows=1703  vars=22)
(BCBS Texas negotiated prices (1 row = 1 distinct price). See 300_labels.do.)
  - bcbstx_prices.dta  (rows=2097564  vars=33)
(BCBS Texas — Texas organizations by network (network-membership directory; raw).)
  - bcbstx_provider_org_directory.dta  (rows=192438  vars=5)
(BCBSTX price summary by procedure x provider type (all networks))
  - bcbstx_price_summary.dta  (rows=167  vars=20)
(Medicare national allowed amount per code (MPFS/OPPS/IPPS). Built by build_medic)
  - bcbstx_medicare_benchmark.dta  (rows=121  vars=5)

. di as txt _n "03_output/  (figures + tables)"

03_output/  (figures + tables)

. local outfiles : dir "${out}" files "*"

. foreach f of local outfiles {
  2.     di as txt "  - `f'"
  3. }
  - p600_region_colonoscopy.png
  - p600_map_county_99214.png
  - p600_case_professional.png
  - price_summary_by_network.csv
  - price_summary.csv
  - p600_map_senate_price.png
  - p600_case_facility.png
  - p600_map_house_price.png
  - p400_rate_basis.png
  - p600_colonoscopy_by_network.png
  - p600_map_zip_supply.png
  - p600_pct_of_medicare.png
  - p600_dispersion_rank_professional.png
  - p600_rx_brand_generic.png
  - p600_dispersion_by_region.png
  - p600_map_senate_supply.png
  - p600_map_region_99214.png
  - p600_prof_vs_facility.png
  - feasibility_matrix.csv

Built

Last rebuilt 31 May 2026 18:56:32 by ericbooth.