Blue Cross Blue Shield · Maryland · commercial in-network

Blue Cross Blue Shield negotiated rates in Maryland

How Blue Cross Blue Shield's Maryland rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.

Blue Cross Blue Shield in Maryland at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
74
26% below the Maryland median
Rank in state
4 of 4
UHC 131 · Cigna 110 · Aetna 101 · BCBS 74
vs own national
63
BCBS's level vs its national median
Codes where highest
0%
of 228 codes
758 sampled providers745 TINs228 codesMedian 101% of Medicare · method

What the data shows

Generated from Maryland and Blue Cross Blue Shield data only
1

Blue Cross Blue Shield ranks 4th of 4 payers in Maryland with a rate index of 74 (100 = the Maryland market median), across 228 procedure codes.

2

Blue Cross Blue Shield has the highest median for only 0% of codes in Maryland; UnitedHealthcare leads with an index of 131 in the files analyzed.

3

Blue Cross Blue Shield's Maryland rates sit 37% below its own national level, the 51st highest of its 51 states.

4

Largest premium over the Maryland market: CPT 88342 (Imhchem/imcytchm 1st antb) at 115% of market; largest discount: CPT 77280 (Ther rad simulaj field smpl) at 15%.

5

In Maryland, BCBS rates come from 38 licensee file sets; the largest is Carefirst BCBS (679 sampled providers).

How the four payers compare in Maryland

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1311
131
63%606
Cigna1102
110
13%723
Aetna1013
101
24%645
Blue Cross Blue Shield744
74
0%758

Where Blue Cross Blue Shield pays most and least against the Maryland market

Codes with the largest gap to the state median

Highest above market

CodeBCBSMarketGapProv.
88342
Imhchem/imcytchm 1st antb
$103$89+15%98
93297
Rem interrog dev eval icpms
$60$56+7%102
99454
Rem mntr physiol param 16-30
$58$58+0%181
96910
Photchmtx tar&uvb/ptrltm&uvb
$116$116+0%100
92235
Fluorescein angrph mltiframe
$145$145+0%91
88305
Tissue exam by pathologist
$64$64+0%197
92025
Cptrized corneal topography
$37$37+0%91
88313
Special stains group 2
$66$66-0%99

Furthest below market

CodeBCBSMarketGapProv.
77280
Ther rad simulaj field smpl
$36$240-85%98
92242
Fluorescein&icg angiography
$47$268-83%91
73610
X-ray exam of ankle
$8$46-83%91
93308
Tte f-up or lmtd
$23$114-80%102
77066
Dx mammo incl cad bi
$45$195-77%95
92273
Full field erg w/i&r
$30$117-74%90
71046
X-ray exam chest 2 views
$11$36-70%94
77049
Mri breast c-+ w/cad bi
$135$436-69%95

Where Blue Cross Blue Shield pays above and below its national level

Index vs the payer's own national median (100 = national)

Highest states

StateIndexProv.
Alaska243
290
Wisconsin192
733
Minnesota171
671
North Dakota148
329
Wyoming145
256

Lowest states

StateIndexProv.
Maryland63
758
Arizona66
479
Texas69
1,003
District of Columbia69
484
New Mexico74
562

Blue Cross Blue Shield licensees in Maryland

File sets contributing rates; licensees are different companies
Licensee file setSampled providers
Carefirst BCBS679
Community Insurance Company164
HealthKeepers, Inc.35
Capital BC26
Capital BlueCross26
BCBS NC24
BCBS TX24
Healthy Alliance Life Insurance Company17
Matthew Thornton Health Plan, Inc.16
Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.13
BCBS NJ (Horizon)12
Horizon Healthcare of New Jersey12
Anthem (Elevance)11
BCBS IL11
BCBS MN9
Blue Shield of California Life & Health Insurance Company6
Compcare Health Services Insurance Corporation6
BCBS MI6
BS CA6
BCBS MA6
Wellmark5
Excellus BCBS5
Regence5
BCBS KS4
Blue Cross Blue Shield of North Dakota4
BCBS TN4
Blue Cross Blue Shield of Wyoming4
BCBS RI4
BCBS Kansas City3
BCBS OK3
Blue Cross and Blue Shield of Nebraska2
BCBS AL2
BCBS NM2
BCBS MT2
HMO Colorado, Inc.1
Premera1
BCBS AZ1
BCBS HI1

Frequently asked questions

Does Blue Cross Blue Shield pay more or less than the other payers in Maryland?

Blue Cross Blue Shield ranks 4th of 4 in Maryland with an index of 74. It is highest on 0% of codes.

Are Blue Cross Blue Shield's Maryland rates above or below its national level?

About 37% below.

Which procedure does Blue Cross Blue Shield pay most above market in Maryland?

CPT 88342 (Imhchem/imcytchm 1st antb), at 115% of the Maryland 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.

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