Cities with the least competitive commercial insurance markets

The report, published Nov. 1, compared commercial, exchange and Medicare Advantage markets at the state and city level. 

Here are the cities where one payer controls upwards of three-quarters of the market in PPO, HMO, point of service and exchange plans. 

Over 90 percent 

• Anniston-Oxford, Ala. — Blue Cross Blue Shield Alabama, 92 percent market share 
• Tuscaloosa, Ala. — Blue Cross Blue Shield Alabama, 92 percent market share 
• Gadsden, Ala. — Blue Cross Blue Shield Alabama, 91 percent market share
• Dothan, Ala. — Blue Cross Blue Shield Alabama, 90 percent market share

Over 80 percent 

• Florence-Muscle Shoals, Ala. — Blue Cross Blue Shield Alabama, 89 percent market share
• Huntsville, Ala. — Blue Cross Blue Shield Alabama, 89 percent market share
• Mobile, Ala. — Blue Cross Blue Shield Alabama, 89 percent market share
• Decatur, Ala. —-  Blue Cross Blue Shield Alabama, 89 percent  market share
• Auburn-Opelika, Ala. — Blue Cross Blue Shield Alabama, 85 percent market share
• Tallahassee, Fla. — Blue Cross Blue Shield of Florida, 85 percent market share
• Birmingham-Hoover, Ala. — Blue Cross Blue Shield Alabama, 84 percent market share
• Daphne-Fairhope-Foley, Ala. —  Blue Cross Blue Shield Alabama, 83 percent market share
• Ann Arbor, Mich. — Blue Cross Blue Shield Michigan, 82 percent market share
• Atlantic City-Hammonton, N.J — Horizon Blue Cross Blue Shield, 80 percent market share
• Goldsboro, N.C — Blue Cross Blue Shield North Carolina, 80 percent market share 

Over 75 percent 

• Greenville, N.C — Blue Cross Blue Shield North Carolina, 79 percent market share
• New Bern, N.C  — Blue Cross Blue Shield North Carolina, 79 percent market share
• Manhattan, Kan. — Blue Cross Blue Shield Kansas, 76 percent market share
• Battle Creek, Mich. — Blue Cross Blue Shield Michigan, 76 percent market share
• Bay City, Mich. — Blue Cross Blue Shield Michigan, 76 percent market share
• Jackson, Mich. — Blue Cross Blue Shield Michigan, 76 percent market share
• Lawton, Okla. — Health Care Service Corp. (BCBS), 76 percent market share