Blue Cross Blue Shield · Colorado · commercial in-network
Blue Cross Blue Shield negotiated rates in Colorado
How Blue Cross Blue Shield's Colorado rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Colorado at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
100
0% above the Colorado median
Rank in state
2 of 4
UHC 113 · BCBS 100 · Cigna 94 · Aetna 82
vs own national
105
BCBS's level vs its national median
Codes where highest
22%
of 228 codes
What the data shows
Generated from Colorado and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 2nd of 4 payers in Colorado with a rate index of 100 (100 = the Colorado market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 22% of codes in Colorado; UnitedHealthcare leads with an index of 113 in the files analyzed.
3
Blue Cross Blue Shield's Colorado rates sit 5% above its own national level, the 18th highest of its 51 states.
4
Largest premium over the Colorado market: CPT 93298 (Rem interrog dev eval scrms) at 193% of market; largest discount: CPT 93971 (Extremity study) at 70%.
5
In Colorado, BCBS rates come from 40 licensee file sets; the largest is Healthy Alliance Life Insurance Company (485 sampled providers).
How the four payers compare in Colorado
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 113 | 1 | 74% | 749 | |
| Blue Cross Blue Shield | 100 | 2 | 22% | 796 | |
| Cigna | 94 | 3 | 3% | 752 | |
| Aetna | 82 | 4 | 1% | 717 |
Where Blue Cross Blue Shield pays most and least against the Colorado market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $153 | $79 | +93% | 115 |
| 97110 Therapeutic exercises | $70 | $37 | +88% | 91 |
| 93297 Rem interrog dev eval icpms | $98 | $66 | +49% | 120 |
| 72148 Mri lumbar spine w/o dye | $600 | $424 | +41% | 153 |
| 70450 Ct head/brain w/o dye | $279 | $211 | +32% | 94 |
| 73721 Mri jnt of lwr extre w/o dye | $582 | $449 | +30% | 153 |
| 70551 Mri brain stem w/o dye | $558 | $431 | +30% | 94 |
| 73221 Mri joint upr extrem w/o dye | $586 | $452 | +30% | 153 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93971 Extremity study | $126 | $181 | -30% | 111 |
| 36482 Endoven ther chem adhes 1st | $175 | $248 | -30% | 119 |
| 93970 Extremity study | $199 | $280 | -29% | 232 |
| 93880 Extracranial bilat study | $202 | $279 | -28% | 338 |
| 93925 Lower extremity study | $254 | $332 | -24% | 120 |
| 45384 Colonoscopy w/lesion removal | $363 | $431 | -16% | 110 |
| 26055 Incise finger tendon sheath | $486 | $572 | -15% | 91 |
| 64566 Neuroeltrd stim post tibial | $50 | $58 | -14% | 91 |
Where Blue Cross Blue Shield pays above and below its national level
Index vs the payer's own national median (100 = national)
Highest states
| State | Index | Prov. | |
|---|---|---|---|
| Alaska | 243 | 290 | |
| Wisconsin | 192 | 733 | |
| Minnesota | 171 | 671 | |
| North Dakota | 148 | 329 | |
| Wyoming | 145 | 256 |
Lowest states
| State | Index | Prov. | |
|---|---|---|---|
| Maryland | 63 | 758 | |
| Arizona | 66 | 479 | |
| Texas | 69 | 1,003 | |
| District of Columbia | 69 | 484 | |
| New Mexico | 74 | 562 |
Blue Cross Blue Shield licensees in Colorado
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Healthy Alliance Life Insurance Company | 485 |
| Matthew Thornton Health Plan, Inc. | 319 |
| HMO Missouri, Inc. | 179 |
| Community Insurance Company | 100 |
| Blue Cross Blue Shield of Wyoming | 82 |
| BCBS TX | 45 |
| HealthKeepers, Inc. | 39 |
| BCBS KS | 29 |
| BCBS NC | 27 |
| BCBS NM | 23 |
| Anthem (Elevance) | 18 |
| BCBS MT | 18 |
| BCBS IL | 16 |
| BCBS HI | 16 |
| Blue Shield of California Life & Health Insurance Company | 15 |
| BS CA | 14 |
| Blue Cross and Blue Shield of Nebraska | 14 |
| BCBS MI | 14 |
| BCBS MN | 10 |
| Wellmark | 10 |
| Regence | 9 |
| BCBS TN | 9 |
| Excellus BCBS | 8 |
| Premera | 8 |
| Compcare Health Services Insurance Corporation | 8 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 7 |
| BCBS OK | 7 |
| BCBS MA | 7 |
| BCBS NJ (Horizon) | 6 |
| Horizon Healthcare of New Jersey | 6 |
| HMO Colorado, Inc. | 5 |
| Blue Cross Blue Shield of North Dakota | 5 |
| Capital BlueCross | 3 |
| BCBS Kansas City | 3 |
| Capital BC | 3 |
| Carefirst BCBS | 3 |
| BCBS AZ | 2 |
| BCBS RI | 2 |
| Blue Cross and Blue Shield of Massachusetts, Inc. | 1 |
| BCBS VT | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Colorado?
Blue Cross Blue Shield ranks 2nd of 4 in Colorado with an index of 100. It is highest on 22% of codes.
Are Blue Cross Blue Shield's Colorado rates above or below its national level?
About 5% above.
Which procedure does Blue Cross Blue Shield pay most above market in Colorado?
CPT 93298 (Rem interrog dev eval scrms), at 193% of the Colorado median.
Methodology
How these numbers are calculated
- Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
- Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
- Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
- Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
- Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
- Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.
Is your Blue Cross Blue Shield contract at market in Colorado?
Compare your negotiated rates for these codes with Colorado medians for each payer.