Blue Cross Blue Shield employer health plans in New York
Who Blue Cross Blue Shield insures among New York employers and what those plans pay in premium and broker compensation, and what the Blue Cross Blue Shield network pays physicians and hospitals.
Blue Cross Blue Shield employer health plans in New York at a glance
What the data shows
Blue Cross Blue Shield insures 603 employer health plans in New York (22% of 2,760 insured large plans), 2nd of 8 carrier groups; Cigna (799) hold more.
Blue Cross Blue Shield has shrunk 9% in New York since 2020, from 666 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (336 plans); 27 cover 1,000 or more.
Median premium per person covered was $10,634, 17% above the New York all-carrier median of $9,072. Benefit design and group mix differ, so this is not a price comparison.
83% of these plans reported broker or agent pay on their Blue Cross Blue Shield contracts; where paid, the median was 3.7% of premium (middle half 2.8%–4.2%).
In BCBS: Excellus BCBS, 24 of the 50 Employer 50 services have a New York benchmark, at a median of 96% of Medicare across those services.
At New York hospitals, Blue Cross Blue Shield's commercial rates run higher than other carriers' at the same hospital for 11 of 17 services; a hip or knee replacement stay has a median rate of $24,914 across 10 hospitals.
Blue Cross Blue Shield plans in New York, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 666 | 239,343 | 24% | $8,624 |
| 2021 | 642 | 228,034 | 24% | $8,984 |
| 2022 | 622 | 220,920 | 22% | $9,188 |
| 2023 | 619 | 207,498 | 22% | $9,851 |
| 2024 | 603 | 203,799 | 22% | $10,634 |
| 2025 (partial) | 440 | 143,061 | 22% | $11,962 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 209 | 35% |
| 100–499 | 336 | 56% |
| 500–999 | 29 | 5% |
| 1,000–4,999 | 22 | 4% |
| 5,000 or more | 5 | 1% |
Premiums and broker pay
| Measure | Blue Cross Blue Shield | All carriers, New York |
|---|---|---|
| Median premium per person covered | $10,634 | $9,072 |
| Premium per person, middle half | $7,121–$14,038 | $5,677–$12,803 |
| Plans reporting broker or agent pay | 83% | 79% |
| Median broker pay, % of premium | 3.7% | 4.1% |
| Broker pay, middle half | 2.8%–4.2% | 3.0%–5.4% |
| Median broker pay per person covered | $410 | $371 |
Industries
Blue Cross Blue Shield's New York employer clients are concentrated in manufacturing (105 plans) and health care and social assistance (104), followed by professional and technical services (84).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 105 | 17% |
| Health care and social assistance | 104 | 17% |
| Professional and technical services | 84 | 14% |
| Finance and insurance | 51 | 8% |
| Retail trade | 50 | 8% |
| Construction | 41 | 7% |
Blue Cross Blue Shield employer clients in New York
568 employers in New York have a Blue Cross Blue Shield major-medical contract, 27 of them covering 1,000 or more people. For each one Medlyze has the plan year, the broker on each contract and what that broker was paid, and compiles the list for a state, an industry or a single employer on request.
| Employer | Persons covered | Plan year ends | Broker | Broker pay, % of premium |
|---|---|---|---|---|
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
Brokers: request the Blue Cross Blue Shield Prospect List for New York →
What the Blue Cross Blue Shield network pays physicians in New York
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Echocardiogram, transthoracic complete with Doppler | 93306 | $65 | $60–$67 | 96% | $99 | 32 |
| Electrocardiogram (EKG), complete | 93000 | $15 | $14–$15 | 96% | $22 | 32 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $73 | $70–$75 | 98% | $92 | 32 |
| Treadmill stress test, complete | 93015 | $70 | $66–$73 | 95% | $110 | 32 |
| Skin biopsy, single lesion (tangential) | 11102 | $91 | $89–$91 | 96% | $133 | 16 |
| Abdominal ultrasound, complete | 76700 | $37 | $36–$40 | 98% | $55 | 39 |
| Bone density scan (DXA), axial | 77080 | $9 | $9–$9 | 98% | $14 | 39 |
| CT abdomen and pelvis with contrast | 74177 | $82 | $82–$99 | 97% | $121 | 39 |
| CT chest without contrast | 71250 | $48 | $48–$57 | 98% | $72 | 39 |
| Chest X-ray, 2 views | 71046 | $10 | $10–$12 | 98% | $15 | 39 |
| MRI brain without and with contrast | 70553 | $103 | $103–$118 | 98% | $156 | 39 |
| MRI cervical spine without contrast | 72141 | $66 | $66–$77 | 98% | $112 | 39 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $61 | $61–$69 | 98% | $107 | 39 |
| MRI lumbar spine without contrast | 72148 | $67 | $67–$76 | 98% | $112 | 39 |
| MRI shoulder (upper-extremity joint) without contrast | 73221 | $62 | $62–$69 | 98% | $108 | 39 |
Professional fee only: facility, implant and anesthesia charges are not included. Limited: rates come from a sample of providers, and groups are counted only in specialties that perform the service.
What the Blue Cross Blue Shield network pays hospitals in New York
Blue Cross Blue Shield commercial rates are on record at 34 New York hospitals (the hospitals covered so far, not every hospital). Compared at the same hospitals, Blue Cross Blue Shield's rate is higher than the other carriers' median for 11 of 17 services and lower for 3. For MRI, lower back, the rate runs from $120 to $2,005 across 18 hospitals.
This page shows 3 of the 17 services in full. The other rates, the size of each gap and every hospital's prices are in the Plan Cost Benchmark.
| Service | Hospitals | Median rate | Range (P10–P90) | vs other carriers, same hospitals | Cash price, median |
|---|---|---|---|---|---|
| Hip or knee replacement (hospital stay) | 10 | $24,914 | $20,032–$34,919 | Higher | – |
| C-section delivery (hospital stay) | 10 | Locked | Locked | Higher | Locked |
| Vaginal delivery (hospital stay) | 11 | Locked | Locked | Higher | Locked |
| MRI, lower back | 18 | $359 | $120–$2,005 | Lower | $343 |
| MRI, knee | 19 | Locked | Locked | About the same | Locked |
| CT, head | 18 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 19 | Locked | Locked | About the same | Locked |
| Screening mammogram | 17 | Locked | Locked | Higher | Locked |
| Colonoscopy, diagnostic | 18 | Locked | Locked | Higher | Locked |
| Upper GI endoscopy with biopsy | 18 | Locked | Locked | Higher | Locked |
| Knee arthroscopy | 19 | Locked | Locked | Higher | Locked |
| Cataract surgery | 17 | Locked | Locked | About the same | Locked |
| Gallbladder removal, laparoscopic | 18 | Locked | Locked | Higher | Locked |
| Knee replacement, outpatient | 19 | Locked | Locked | Higher | Locked |
| Emergency visit, level 4 | 16 | $186 | $125–$1,758 | Higher | $301 |
| Comprehensive metabolic panel | 21 | Locked | Locked | Lower | Locked |
| Complete blood count | 21 | Locked | Locked | Lower | Locked |
Hospitals with the most published Blue Cross Blue Shield rates
| Hospital | Joint replacement | MRI lower back | CT abdomen | Colonoscopy | ER level 4 | Vaginal delivery |
|---|---|---|---|---|---|---|
| Ahn Westfield Memorial Hospital | – | Locked | Locked | Locked | Locked | Locked |
| Claxton-hepburn Medical Center | $20,032 | Locked | Locked | Locked | Locked | Locked |
| Clifton Springs Hospital | $24,914 | Locked | Locked | Locked | Locked | Locked |
| Geneva General Hospital | – | Locked | Locked | Locked | Locked | Locked |
| Jones Memorial Hospital | – | Locked | Locked | Locked | Locked | Locked |
| Newark-wayne Community Hospital | $34,000 | Locked | Locked | Locked | Locked | Locked |
| Noyes Memorial Hospital | – | Locked | Locked | Locked | Locked | Locked |
| Samaritan Medical Center | $26,894 | Locked | Locked | Locked | Locked | Locked |
| St. James Hospital | – | Locked | Locked | Locked | Locked | Locked |
| United Memorial Medical Center | $43,378 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 9%, fee schedules 75%, per diem 0%, percent of billed charges 8%, other 8% of Blue Cross Blue Shield's published commercial rates for these services in New York.
Employers: see all 17 services and every hospital near your people in a Plan Cost Benchmark →
Hospital facility rate only: physician, anesthesia and implant charges are separate. Rates are what hospitals publish, not claims paid, and are not weighted by use.
Carriers in New York
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Cigna | 799 | 29% | $8,959 | 5.4% |
| Blue Cross Blue Shield | 603 | 22% | $10,634 | 3.7% |
| UnitedHealthcare | 532 | 19% | $9,011 | 4.3% |
| Other insurers (regional and local plans) | 530 | 19% | $8,835 | 3.8% |
| Aetna | 348 | 13% | $8,436 | 4.2% |
| Anthem (Elevance Health) | 270 | 10% | $8,845 | 4.0% |
| Kaiser Permanente | 244 | 9% | $9,169 | 4.2% |
| Humana | 10 | 0% | $3,012 | 3.5% |
Blue Cross Blue Shield in other states
FAQ
How many New York employers have Blue Cross Blue Shield health insurance?
603 employer health plans in New York reported a Blue Cross Blue Shield major-medical contract in their 2024 filings, covering 203,799 persons. Self-funded plans that Blue Cross Blue Shield only administers are not counted.
What is Blue Cross Blue Shield's share of the New York insured employer market?
22% of insured large employer health plans, 2nd of 8 carrier groups by plan count.
How much do brokers earn on Blue Cross Blue Shield plans in New York?
Where broker or agent pay was reported, the median was 3.7% of premium (4.1% across all carriers in New York).
Can I see the figures for a specific employer?
Yes. Brokers can request an Employer Account Brief on one employer, or a Prospect List for this market. Employers can request a Plan Cost Benchmark for their own plan. Use the request form on this page.
About these numbers
- Plans counted: the 603 New York employer health plans with a Blue Cross Blue Shield major-medical contract in their 2024 filings. Self-funded plans that Blue Cross Blue Shield only administers are not counted here.
- Premium and broker figures: 533 contracts with 20+ persons covered and a reported premium; broker percentages use the 493 contracts that reported broker or agent pay.
- Network rates: BCBS: Excellus BCBS, professional fees only, from a sample of providers.
- Hospital prices: Blue Cross Blue Shield commercial rates at New York hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.