Blue Cross Blue Shield · Kentucky · commercial in-network
Blue Cross Blue Shield negotiated rates in Kentucky
How Blue Cross Blue Shield's Kentucky rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Kentucky at a glance
Across 228 procedure codes for 8 specialties
Rate index vs state market
89
11% below the Kentucky median
Rank in state
3 of 4
UHC 114 · Cigna 111 · BCBS 89 · Aetna 82
vs own national
80
BCBS's level vs its national median
Codes where highest
3%
of 228 codes
What the data shows
Generated from Kentucky and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 3rd of 4 payers in Kentucky with a rate index of 89 (100 = the Kentucky market median), across 228 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 3% of codes in Kentucky; UnitedHealthcare leads with an index of 114 in the files analyzed.
3
Blue Cross Blue Shield's Kentucky rates sit 20% below its own national level, the 42nd highest of its 51 states.
4
Largest premium over the Kentucky market: CPT 73721 (Mri jnt of lwr extre w/o dye) at 120% of market; largest discount: CPT 88313 (Special stains group 2) at 13%.
5
In Kentucky, BCBS rates come from 39 licensee file sets; the largest is Anthem (Elevance) (840 sampled providers).
How the four payers compare in Kentucky
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 114 | 1 | 53% | 820 | |
| Cigna | 111 | 2 | 43% | 848 | |
| Blue Cross Blue Shield | 89 | 3 | 3% | 935 | |
| Aetna | 82 | 4 | 2% | 681 |
Where Blue Cross Blue Shield pays most and least against the Kentucky market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 73721 Mri jnt of lwr extre w/o dye | $399 | $332 | +20% | 249 |
| 73221 Mri joint upr extrem w/o dye | $399 | $334 | +20% | 249 |
| 72141 Mri neck spine w/o dye | $427 | $366 | +17% | 126 |
| 72148 Mri lumbar spine w/o dye | $420 | $360 | +16% | 249 |
| 11301 Shave skin lesion 0.6-1.0 cm | $86 | $74 | +16% | 109 |
| 17313 Mohs 1 stage t/a/l | $555 | $480 | +16% | 109 |
| 92012 Intrm oph exam est patient | $77 | $68 | +13% | 107 |
| 70553 Mri brain stem w/o & w/dye | $579 | $521 | +11% | 126 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 88313 Special stains group 2 | $8 | $61 | -87% | 112 |
| 88312 Special stains group 1 | $40 | $83 | -52% | 227 |
| 88342 Imhchem/imcytchm 1st antb | $46 | $83 | -44% | 108 |
| 33285 Insj subq car rhythm mntr | $83 | $131 | -37% | 112 |
| 64566 Neuroeltrd stim post tibial | $36 | $57 | -36% | 113 |
| 52287 Cystoscopy chemodenervation | $218 | $328 | -34% | 113 |
| 67840 Remove eyelid lesion | $152 | $227 | -33% | 107 |
| 93925 Lower extremity study | $235 | $350 | -33% | 121 |
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 Kentucky
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Anthem (Elevance) | 840 |
| Community Insurance Company | 211 |
| HealthKeepers, Inc. | 119 |
| Healthy Alliance Life Insurance Company | 106 |
| BCBS TX | 25 |
| BCBS TN | 18 |
| BCBS NC | 17 |
| BCBS IL | 14 |
| Matthew Thornton Health Plan, Inc. | 13 |
| BCBS MI | 8 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 7 |
| Regence | 5 |
| Carefirst BCBS | 5 |
| BCBS MA | 5 |
| BCBS NM | 4 |
| Excellus BCBS | 4 |
| BS CA | 4 |
| Wellmark | 3 |
| Blue Shield of California Life & Health Insurance Company | 3 |
| Horizon Healthcare of New Jersey | 3 |
| BCBS RI | 3 |
| Blue Cross and Blue Shield of Nebraska | 3 |
| Blue Cross Blue Shield of Wyoming | 3 |
| Compcare Health Services Insurance Corporation | 3 |
| HMO Colorado, Inc. | 3 |
| BCBS NJ (Horizon) | 3 |
| BCBS MS | 3 |
| HMO Missouri, Inc. | 2 |
| Blue Cross Blue Shield of North Dakota | 2 |
| BCBS MN | 2 |
| BCBS VT | 2 |
| BCBS KS | 2 |
| BCBS AL | 2 |
| BCBS MT | 1 |
| BCBS OK | 1 |
| Capital BC | 1 |
| Capital BlueCross | 1 |
| Premera | 1 |
| BCBS AZ | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Kentucky?
Blue Cross Blue Shield ranks 3rd of 4 in Kentucky with an index of 89. It is highest on 3% of codes.
Are Blue Cross Blue Shield's Kentucky rates above or below its national level?
About 20% below.
Which procedure does Blue Cross Blue Shield pay most above market in Kentucky?
CPT 73721 (Mri jnt of lwr extre w/o dye), at 120% of the Kentucky 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 Kentucky?
Compare your negotiated rates for these codes with Kentucky medians for each payer.