Anthem's confidential pricing and two Denver urgent care bills

Anthem’s “Confidential” Pricing: Still Fighting Against Transparency?

After a Denver couple visited urgent care for the same issue, one received a $1,800 bill (Anthem), while the other paid just $21 (Cigna). Both had high-deductible plans and hadn’t met their deductibles.

When questioned, Anthem Blue Cross and Blue Shield said:

“While Anthem’s specific negotiated rates with health systems are confidential, we are transparent with Anthem members about the price of health care services.”

But!!!

Under the Consolidated Appropriations Act (CAA 2021) and federal Transparency in Coverage rules, insurers must disclose their negotiated rates with providers. Confidential pricing is not allowed.

Anthem’s comment raises red flags:
• Insurers cannot hide behind “confidentiality” to avoid price transparency.
• Patients need access to real, negotiated rates to make informed decisions.
• Anthem nonetheless believes they do not have to publish negotiated rates.

In this case, a simple lab test—billed at 4x Medicare rates—reveals the chicanery of rate negotiation.

Transparency isn’t optional. It’s the law. Patients deserve to know what they’ll pay—and pay a fair amount. Anthem’s response sidesteps this obligation and highlights why enforcement of transparency rules is critical.