Blue Cross Blue Shield · Maine · commercial in-network
Blue Cross Blue Shield negotiated rates in Maine
How Blue Cross Blue Shield's Maine rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Maine at a glance
Across 159 procedure codes for 8 specialties
Rate index vs state market
103
3% above the Maine median
Rank in state
2 of 4
UHC 124 · BCBS 103 · Cigna 100 · Aetna 85
vs own national
103
BCBS's level vs its national median
Codes where highest
18%
of 159 codes
What the data shows
Generated from Maine and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 2nd of 4 payers in Maine with a rate index of 103 (100 = the Maine market median), across 159 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 18% of codes in Maine; UnitedHealthcare leads with an index of 124 in the files analyzed.
3
Blue Cross Blue Shield's Maine rates sit 3% above its own national level, the 20th highest of its 51 states.
4
Largest premium over the Maine market: CPT 93298 (Rem interrog dev eval scrms) at 449% of market; largest discount: CPT 92004 (Compre oph exam new pt 1/>) at 55%.
5
In Maine, BCBS rates come from 34 licensee file sets; the largest is Compcare Health Services Insurance Corporation (100 sampled providers).
How the four payers compare in Maine
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 124 | 1 | 74% | 546 | |
| Blue Cross Blue Shield | 103 | 2 | 18% | 215 | |
| Cigna | 100 | 3 | 9% | 597 | |
| Aetna | 85 | 4 | 4% | 552 |
Where Blue Cross Blue Shield pays most and least against the Maine market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $203 | $45 | +349% | 34 |
| 93296 Rem interrog evl pm/ids | $63 | $35 | +80% | 32 |
| 71271 Ct thorax lung cancer scr c- | $291 | $193 | +51% | 69 |
| 75574 Ct angio hrt w/3d image | $696 | $471 | +48% | 31 |
| 88305 Tissue exam by pathologist | $103 | $70 | +47% | 23 |
| 74178 Ct abd&plv wo cntr flwd cntr | $723 | $491 | +47% | 82 |
| 74177 Ct abd & pelvis w/contrast | $642 | $439 | +46% | 68 |
| 74176 Ct abd & pelvis w/o contrast | $391 | $269 | +46% | 68 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 92004 Compre oph exam new pt 1/> | $80 | $144 | -45% | 21 |
| 92014 Compre oph exam est pt 1/> | $80 | $121 | -34% | 21 |
| 20550 Njx 1 tendon sheath/ligament | $49 | $74 | -34% | 20 |
| 99457 Rpm tx mgmt 1st 20 min | $42 | $57 | -27% | 58 |
| 93971 Extremity study | $132 | $173 | -24% | 69 |
| 93880 Extracranial bilat study | $214 | $277 | -23% | 126 |
| 93970 Extremity study | $208 | $269 | -23% | 103 |
| 55874 Tprnl plmt biodegrdabl matrl | $206 | $263 | -22% | 15 |
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 Maine
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| Compcare Health Services Insurance Corporation | 100 |
| Anthem (Elevance) | 89 |
| Community Insurance Company | 46 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 30 |
| HealthKeepers, Inc. | 23 |
| BCBS MA | 22 |
| Matthew Thornton Health Plan, Inc. | 15 |
| Healthy Alliance Life Insurance Company | 15 |
| BCBS NC | 14 |
| BCBS TX | 13 |
| BCBS MI | 9 |
| Horizon Healthcare of New Jersey | 6 |
| Excellus BCBS | 6 |
| BCBS NJ (Horizon) | 6 |
| BCBS IL | 5 |
| BS CA | 5 |
| BCBS VT | 5 |
| BCBS NM | 5 |
| Carefirst BCBS | 5 |
| Blue Shield of California Life & Health Insurance Company | 5 |
| BCBS RI | 5 |
| BCBS MN | 4 |
| Capital BlueCross | 4 |
| Capital BC | 4 |
| Wellmark | 4 |
| BCBS OK | 3 |
| BCBS TN | 3 |
| Premera | 3 |
| Regence | 3 |
| Blue Cross and Blue Shield of Massachusetts, Inc. | 3 |
| Blue Cross Blue Shield of North Dakota | 2 |
| Blue Cross Blue Shield of Wyoming | 1 |
| BCBS AL | 1 |
| Blue Cross and Blue Shield of Nebraska | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Maine?
Blue Cross Blue Shield ranks 2nd of 4 in Maine with an index of 103. It is highest on 18% of codes.
Are Blue Cross Blue Shield's Maine rates above or below its national level?
About 3% above.
Which procedure does Blue Cross Blue Shield pay most above market in Maine?
CPT 93298 (Rem interrog dev eval scrms), at 449% of the Maine 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 Maine?
Compare your negotiated rates for these codes with Maine medians for each payer.