Blue Cross Blue Shield negotiated rates in Connecticut
How Blue Cross Blue Shield's Connecticut rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Connecticut at a glance
What the data shows
Blue Cross Blue Shield ranks 3rd of 4 payers in Connecticut with a rate index of 100 (100 = the Connecticut market median), across 228 procedure codes.
Blue Cross Blue Shield has the highest median for only 12% of codes in Connecticut; UnitedHealthcare leads with an index of 127 in the files analyzed.
Blue Cross Blue Shield's Connecticut rates sit 29% above its own national level, the 8th highest of its 51 states.
Largest premium over the Connecticut market: CPT 93312 (Echo transesophageal) at 153% of market; largest discount: CPT 11104 (Punch bx skin single lesion) at 58%.
In Connecticut, BCBS rates come from 35 licensee file sets; the largest is Matthew Thornton Health Plan, Inc. (827 sampled providers).
How the four payers compare in Connecticut
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 127 | 1 | 69% | 804 | |
| Cigna | 107 | 2 | 18% | 855 | |
| Blue Cross Blue Shield | 100 | 3 | 12% | 887 | |
| Aetna | 79 | 4 | 0% | 754 |
Where Blue Cross Blue Shield pays most and least against the Connecticut market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93312 Echo transesophageal | $892 | $582 | +53% | 109 |
| 76775 Us exam abdo back wall lim | $144 | $97 | +48% | 108 |
| 96372 Ther/proph/diag inj sc/im | $53 | $38 | +39% | 115 |
| 96413 Chemo iv infusion 1 hr | $432 | $318 | +36% | 116 |
| 74177 Ct abd & pelvis w/contrast | $774 | $578 | +34% | 110 |
| 99496 Transj care mgmt high f2f 7d | $403 | $307 | +31% | 115 |
| 43235 Egd diagnostic brush wash | $482 | $370 | +30% | 116 |
| 76857 Us exam pelvic limited | $102 | $79 | +29% | 108 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 11104 Punch bx skin single lesion | $65 | $113 | -42% | 107 |
| 11102 Tangntl bx skin single les | $52 | $90 | -42% | 107 |
| 92136 Ophthalmic biometry | $73 | $105 | -30% | 105 |
| 17311 Mohs 1 stage h/n/hf/g | $491 | $687 | -28% | 107 |
| 93925 Lower extremity study | $335 | $450 | -26% | 109 |
| 92250 Fundus photography w/i&r | $58 | $77 | -25% | 105 |
| 11302 Shave skin lesion 1.1-2.0 cm | $83 | $110 | -25% | 107 |
| 64566 Neuroeltrd stim post tibial | $57 | $72 | -21% | 98 |
Where Blue Cross Blue Shield pays above and below its national level
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 Connecticut
| Licensee file set | Sampled providers |
|---|---|
| Matthew Thornton Health Plan, Inc. | 827 |
| Community Insurance Company | 111 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 58 |
| BCBS MA | 55 |
| HealthKeepers, Inc. | 35 |
| Horizon Healthcare of New Jersey | 18 |
| BCBS NJ (Horizon) | 18 |
| Healthy Alliance Life Insurance Company | 16 |
| BCBS RI | 15 |
| Anthem (Elevance) | 12 |
| BCBS TX | 9 |
| BCBS NC | 9 |
| Blue Shield of California Life & Health Insurance Company | 8 |
| Carefirst BCBS | 8 |
| BS CA | 8 |
| Compcare Health Services Insurance Corporation | 7 |
| Excellus BCBS | 7 |
| BCBS MI | 6 |
| BCBS TN | 5 |
| Capital BlueCross | 4 |
| Capital BC | 4 |
| Wellmark | 3 |
| BCBS IL | 3 |
| Regence | 3 |
| BCBS MN | 2 |
| Premera | 2 |
| BCBS KS | 2 |
| Blue Cross Blue Shield of North Dakota | 1 |
| BCBS HI | 1 |
| BCBS AL | 1 |
| BCBS MT | 1 |
| BCBS AZ | 1 |
| HMO Colorado, Inc. | 1 |
| BCBS VT | 1 |
| Blue Cross Blue Shield of Wyoming | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Connecticut?
Blue Cross Blue Shield ranks 3rd of 4 in Connecticut with an index of 100. It is highest on 12% of codes.
Are Blue Cross Blue Shield's Connecticut rates above or below its national level?
About 29% above.
Which procedure does Blue Cross Blue Shield pay most above market in Connecticut?
CPT 93312 (Echo transesophageal), at 153% of the Connecticut median.
Methodology
- 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 Connecticut?
Compare your negotiated rates for these codes with Connecticut medians for each payer.