Blue Cross Blue Shield employer health plans in North Carolina
Who Blue Cross Blue Shield insures among North Carolina 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 North Carolina at a glance
What the data shows
Blue Cross Blue Shield is the largest insurer of employer health plans in North Carolina: 478 plans held a Blue Cross Blue Shield major-medical contract in form year 2024, 51% of the state's 939 insured large plans, ahead of Cigna with 186.
The Blue Cross Blue Shield book in North Carolina has held steady since 2020 (469 plans then).
Most of these plans cover 100–499 people (320 plans); 25 cover 1,000 or more.
Median premium per person covered was $6,672, 11% above the North Carolina all-carrier median of $6,006. 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 3.2% of premium (middle half 2.4%–4.5%).
In BCBS: BCBS NC, 31 of the 50 Employer 50 services have a North Carolina benchmark, at a median of 174% of Medicare across those services.
At North Carolina hospitals, Blue Cross Blue Shield's commercial rates run higher than other carriers' at the same hospital for 9 of 14 services; a hip or knee replacement stay has a median rate of $25,371 across 32 hospitals.
Blue Cross Blue Shield plans in North Carolina, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 469 | 182,132 | 50% | $5,622 |
| 2021 | 491 | 193,836 | 51% | $5,773 |
| 2022 | 550 | 200,850 | 52% | $5,911 |
| 2023 | 482 | 191,752 | 49% | $6,262 |
| 2024 | 478 | 189,060 | 51% | $6,672 |
| 2025 (partial) | 267 | 117,125 | 49% | $6,800 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 75 | 16% |
| 100–499 | 320 | 67% |
| 500–999 | 57 | 12% |
| 1,000–4,999 | 23 | 5% |
| 5,000 or more | 2 | 0% |
Premiums and broker pay
| Measure | Blue Cross Blue Shield | All carriers, North Carolina |
|---|---|---|
| Median premium per person covered | $6,672 | $6,006 |
| Premium per person, middle half | $5,217–$8,239 | $3,259–$8,027 |
| Plans reporting broker or agent pay | 83% | 79% |
| Median broker pay, % of premium | 3.2% | 4.0% |
| Broker pay, middle half | 2.4%–4.5% | 2.6%–6.3% |
| Median broker pay per person covered | $211 | $216 |
Industries
Blue Cross Blue Shield's North Carolina employer clients are concentrated in manufacturing (93 plans) and health care and social assistance (79), followed by professional and technical services (66).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 93 | 19% |
| Health care and social assistance | 79 | 17% |
| Professional and technical services | 66 | 14% |
| Wholesale trade | 33 | 7% |
| Construction | 28 | 6% |
| Retail trade | 27 | 6% |
Blue Cross Blue Shield employer clients in North Carolina
441 employers in North Carolina have a Blue Cross Blue Shield major-medical contract, 25 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 North Carolina →
What the Blue Cross Blue Shield network pays physicians in North Carolina
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $604 | $604–$604 | 210% | $507 | 81 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $140 | $132–$155 | 208% | $108 | 97 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $161 | $149–$168 | 217% | $121 | 97 |
| Skin biopsy, single lesion (tangential) | 11102 | $114 | $114–$114 | 119% | $96 | 57 |
| Colonoscopy (diagnostic, with biopsy, with polyp removal) | 45378 | $708 | $708–$708 | 430% | $511 | 86 |
| Upper GI endoscopy (diagnostic, with biopsy) | 43235 | $397 | $397–$397 | 359% | $300 | 86 |
| Cataract removal with lens implant | 66984 | $319 | $319–$319 | 69% | $718 | 70 |
| Abdominal ultrasound, complete | 76700 | $91 | $90–$95 | 243% | $65 | 108 |
| Bone density scan (DXA), axial | 77080 | $23 | $23–$24 | 245% | $16 | 108 |
| CT abdomen and pelvis with contrast | 74177 | $224 | $213–$227 | 267% | $147 | 108 |
| CT chest without contrast | 71250 | $133 | $123–$138 | 270% | $89 | 108 |
| Chest X-ray, 2 views | 71046 | $25 | $25–$26 | 249% | $17 | 108 |
| MRI brain without and with contrast | 70553 | $280 | $272–$291 | 266% | $187 | 108 |
| MRI cervical spine without contrast | 72141 | $186 | $182–$195 | 273% | $124 | 108 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $152 | $152–$162 | 242% | $112 | 108 |
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 North Carolina
Blue Cross Blue Shield commercial rates are on record at 40 North Carolina 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 9 of 14 services and lower for 3. For Emergency visit, level 4, the rate runs from $111 to $1,777 across 19 hospitals.
This page shows 3 of the 14 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) | 32 | $25,371 | $20,744–$35,766 | Higher | – |
| C-section delivery (hospital stay) | 32 | Locked | Locked | Higher | Locked |
| Vaginal delivery (hospital stay) | 30 | Locked | Locked | About the same | Locked |
| MRI, lower back | 20 | $463 | $451–$1,295 | Higher | $2,013 |
| MRI, knee | 20 | Locked | Locked | Higher | Locked |
| CT, head | 22 | Locked | Locked | Lower | Locked |
| CT, abdomen and pelvis | 22 | Locked | Locked | Lower | Locked |
| Screening mammogram | 9 | Locked | Locked | Higher | Locked |
| Colonoscopy, diagnostic | 10 | Locked | Locked | Higher | Locked |
| Upper GI endoscopy with biopsy | 10 | Locked | Locked | Lower | Locked |
| Gallbladder removal, laparoscopic | 10 | Locked | Locked | Higher | Locked |
| Emergency visit, level 4 | 19 | $256 | $111–$1,777 | Higher | $1,591 |
| Comprehensive metabolic panel | 21 | Locked | Locked | About the same | Locked |
| Complete blood count | 21 | Locked | Locked | Higher | 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 |
|---|---|---|---|---|---|---|
| Alleghany Memorial Hospital | – | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Cabarrus | $28,068 | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Carolinas Medical Center | $27,589 | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Kings Mountain | $26,022 | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Mercy | $25,163 | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Stanly | $25,371 | Locked | Locked | Locked | Locked | Locked |
| Atrium Health Union | $25,163 | Locked | Locked | Locked | Locked | Locked |
| Atrium Health University City | $25,163 | Locked | Locked | Locked | Locked | Locked |
| Novant Health Ballantyne Medical Center | $30,700 | Locked | Locked | Locked | Locked | Locked |
| Onslow Memorial Hospital | $24,836 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 4%, fee schedules 43%, per diem 2%, percent of billed charges 45%, other 5% of Blue Cross Blue Shield's published commercial rates for these services in North Carolina.
Employers: see all 14 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 North Carolina
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Blue Cross Blue Shield | 478 | 51% | $6,672 | 3.2% |
| Cigna | 186 | 20% | $2,375 | 8.1% |
| UnitedHealthcare | 153 | 16% | $6,004 | 4.8% |
| Other insurers (regional and local plans) | 89 | 9% | $1,360 | 9.6% |
| Aetna | 66 | 7% | $5,745 | 1.5% |
| Kaiser Permanente | 64 | 7% | $8,943 | 2.9% |
| Anthem (Elevance Health) | 8 | 1% | $6,519 | 5.0% |
| Humana | 3 | 0% | $3,482 | 2.7% |
Blue Cross Blue Shield in other states
FAQ
How many North Carolina employers have Blue Cross Blue Shield health insurance?
478 employer health plans in North Carolina reported a Blue Cross Blue Shield major-medical contract in their 2024 filings, covering 189,060 persons. Self-funded plans that Blue Cross Blue Shield only administers are not counted.
What is Blue Cross Blue Shield's share of the North Carolina insured employer market?
51% of insured large employer health plans, 1st of 8 carrier groups by plan count.
How much do brokers earn on Blue Cross Blue Shield plans in North Carolina?
Where broker or agent pay was reported, the median was 3.2% of premium (4.0% across all carriers in North Carolina).
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 478 North Carolina 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: 439 contracts with 20+ persons covered and a reported premium; broker percentages use the 384 contracts that reported broker or agent pay.
- Network rates: BCBS: BCBS NC, professional fees only, from a sample of providers.
- Hospital prices: Blue Cross Blue Shield commercial rates at North Carolina hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.