Blue Cross Blue Shield employer health plans in Texas
Who Blue Cross Blue Shield insures among Texas 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 Texas at a glance
What the data shows
Blue Cross Blue Shield is the largest insurer of employer health plans in Texas: 1,804 plans held a Blue Cross Blue Shield major-medical contract in form year 2024, 50% of the state's 3,599 insured large plans, ahead of UnitedHealthcare with 734.
Blue Cross Blue Shield has grown 27% in Texas since 2020, from 1,423 plans.
Most of these plans cover 100–499 people (1,180 plans); 181 cover 1,000 or more.
Median premium per person covered was $6,240, 6% above the Texas all-carrier median of $5,901. Benefit design and group mix differ, so this is not a price comparison.
92% of these plans reported broker or agent pay on their Blue Cross Blue Shield contracts; where paid, the median was 4.3% of premium (middle half 3.1%–5.3%).
In BCBS: BCBS TX, 20 of the 50 Employer 50 services have a Texas benchmark, at a median of 91% of Medicare across those services.
At Texas hospitals, Blue Cross Blue Shield's commercial rates run higher than other carriers' at the same hospital for 10 of 17 services; a hip or knee replacement stay has a median rate of $28,567 across 124 hospitals.
Blue Cross Blue Shield plans in Texas, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 1,423 | 883,710 | 44% | $5,384 |
| 2021 | 1,438 | 697,439 | 44% | $5,552 |
| 2022 | 1,597 | 849,512 | 46% | $5,734 |
| 2023 | 1,748 | 845,773 | 48% | $5,937 |
| 2024 | 1,804 | 941,781 | 50% | $6,240 |
| 2025 (partial) | 1,184 | 668,198 | 47% | $6,732 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 176 | 10% |
| 100–499 | 1,180 | 65% |
| 500–999 | 262 | 15% |
| 1,000–4,999 | 170 | 9% |
| 5,000 or more | 11 | 1% |
Premiums and broker pay
| Measure | Blue Cross Blue Shield | All carriers, Texas |
|---|---|---|
| Median premium per person covered | $6,240 | $5,901 |
| Premium per person, middle half | $5,134–$7,369 | $4,055–$7,555 |
| Plans reporting broker or agent pay | 92% | 85% |
| Median broker pay, % of premium | 4.3% | 4.8% |
| Broker pay, middle half | 3.1%–5.3% | 3.4%–6.0% |
| Median broker pay per person covered | $256 | $258 |
Industries
Blue Cross Blue Shield's Texas employer clients are concentrated in manufacturing (269 plans) and health care and social assistance (240), followed by professional and technical services (238).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 269 | 15% |
| Health care and social assistance | 240 | 13% |
| Professional and technical services | 238 | 13% |
| Construction | 175 | 10% |
| Retail trade | 111 | 6% |
| Finance and insurance | 110 | 6% |
Blue Cross Blue Shield employer clients in Texas
1,741 employers in Texas have a Blue Cross Blue Shield major-medical contract, 181 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 Texas →
What the Blue Cross Blue Shield network pays physicians in Texas
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Echocardiogram, transthoracic complete with Doppler | 93306 | $238 | $182–$267 | 121% | $272 | 126 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $365 | $347–$384 | 85% | $429 | 125 |
| Skin biopsy, single lesion (tangential) | 11102 | $113 | $94–$124 | 118% | $107 | 120 |
| Abdominal ultrasound, complete | 76700 | $123 | $117–$141 | 107% | $167 | 78 |
| Bone density scan (DXA), axial | 77080 | $40 | $38–$45 | 102% | $68 | 78 |
| CT abdomen and pelvis with contrast | 74177 | $318 | $302–$364 | 106% | $427 | 78 |
| CT chest without contrast | 71250 | $147 | $141–$169 | 111% | $255 | 78 |
| Chest X-ray, 2 views | 71046 | $35 | $34–$41 | 107% | $40 | 78 |
| MRI brain without and with contrast | 70553 | $345 | $329–$397 | 109% | $598 | 78 |
| MRI cervical spine without contrast | 72141 | $209 | $200–$241 | 110% | $375 | 78 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $217 | $207–$249 | 106% | $377 | 78 |
| MRI lumbar spine without contrast | 72148 | $209 | $200–$241 | 109% | $375 | 78 |
| MRI shoulder (upper-extremity joint) without contrast | 73221 | $218 | $207–$249 | 106% | $380 | 78 |
| Pelvic ultrasound, complete (non-obstetric) | 76856 | $110 | $105–$126 | 105% | $145 | 78 |
| Screening mammography, bilateral (incl. CAD) | 77067 | $133 | $127–$152 | 106% | $180 | 78 |
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 Texas
Blue Cross Blue Shield commercial rates are on record at 216 Texas 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 10 of 17 services and lower for 4. For Emergency visit, level 4, the rate runs from $862 to $23,884 across 101 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) | 124 | $28,567 | $15,257–$55,594 | Higher | $17,621 |
| C-section delivery (hospital stay) | 121 | Locked | Locked | Higher | Locked |
| Vaginal delivery (hospital stay) | 121 | Locked | Locked | Higher | Locked |
| MRI, lower back | 105 | $879 | $543–$1,846 | Higher | $2,887 |
| MRI, knee | 101 | Locked | Locked | Higher | Locked |
| CT, head | 106 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 106 | Locked | Locked | Higher | Locked |
| Screening mammogram | 100 | Locked | Locked | Lower | Locked |
| Colonoscopy, diagnostic | 106 | Locked | Locked | Lower | Locked |
| Upper GI endoscopy with biopsy | 106 | Locked | Locked | Lower | Locked |
| Knee arthroscopy | 112 | Locked | Locked | Lower | Locked |
| Cataract surgery | 112 | Locked | Locked | About the same | Locked |
| Gallbladder removal, laparoscopic | 112 | Locked | Locked | About the same | Locked |
| Knee replacement, outpatient | 114 | Locked | Locked | Higher | Locked |
| Emergency visit, level 4 | 101 | $3,190 | $862–$23,884 | Higher | $1,706 |
| Comprehensive metabolic panel | 104 | Locked | Locked | Higher | Locked |
| Complete blood count | 104 | Locked | Locked | About the same | 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 |
|---|---|---|---|---|---|---|
| Baylor Scott & White Medical Center Trophy Club | $22,292 | Locked | Locked | Locked | Locked | Locked |
| Baylor Scott & White Medical Center Uptown | $21,385 | Locked | Locked | Locked | Locked | Locked |
| Baylor Scott & White Orthopedic And Spine Hospital Arlington | $21,385 | Locked | Locked | Locked | Locked | Locked |
| Baylor Scott & White Surgical Hospital Fort Worth | $22,249 | Locked | Locked | Locked | Locked | Locked |
| Baylor Surgical Hospital At Las Colinas | $21,385 | Locked | Locked | Locked | Locked | Locked |
| Christus Hospital Orange | $25,043 | Locked | Locked | Locked | Locked | Locked |
| Christus Santa Rosa Hospital San Marcos | $20,644 | Locked | Locked | Locked | Locked | Locked |
| Christus Southeast Texas St. Elizabeth | $25,043 | Locked | Locked | Locked | Locked | Locked |
| Corpus Christi Medical Center Bayview | $35,718 | Locked | Locked | Locked | Locked | Locked |
| Covenant Children's Hospital | $48,527 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 15%, fee schedules 61%, per diem 7%, percent of billed charges 13%, other 4% of Blue Cross Blue Shield's published commercial rates for these services in Texas.
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 Texas
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Blue Cross Blue Shield | 1,804 | 50% | $6,240 | 4.3% |
| UnitedHealthcare | 734 | 20% | $5,375 | 5.1% |
| Cigna | 654 | 18% | $2,700 | 7.7% |
| Other insurers (regional and local plans) | 350 | 10% | $3,674 | 6.0% |
| Kaiser Permanente | 271 | 8% | $9,124 | 3.9% |
| Aetna | 190 | 5% | $6,075 | 3.9% |
| Anthem (Elevance Health) | 33 | 1% | $6,897 | 4.8% |
| Humana | 11 | 0% | $3,665 | 5.3% |
Blue Cross Blue Shield in other states
FAQ
How many Texas employers have Blue Cross Blue Shield health insurance?
1,804 employer health plans in Texas reported a Blue Cross Blue Shield major-medical contract in their 2024 filings, covering 941,781 persons. Self-funded plans that Blue Cross Blue Shield only administers are not counted.
What is Blue Cross Blue Shield's share of the Texas insured employer market?
50% 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 Texas?
Where broker or agent pay was reported, the median was 4.3% of premium (4.8% across all carriers in Texas).
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 1,804 Texas 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: 1,719 contracts with 20+ persons covered and a reported premium; broker percentages use the 1,650 contracts that reported broker or agent pay.
- Network rates: BCBS: BCBS TX, professional fees only, from a sample of providers.
- Hospital prices: Blue Cross Blue Shield commercial rates at Texas hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.