Blue Cross Blue Shield · Montana · commercial in-network
Blue Cross Blue Shield negotiated rates in Montana
How Blue Cross Blue Shield's Montana rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Montana at a glance
Across 227 procedure codes for 8 specialties
Rate index vs state market
100
0% above the Montana median
Rank in state
3 of 4
Aetna 123 · UHC 114 · Cigna 100 · BCBS 100
vs own national
96
BCBS's level vs its national median
Codes where highest
4%
of 227 codes
What the data shows
Generated from Montana and Blue Cross Blue Shield data only
1
Blue Cross Blue Shield ranks 3rd of 4 payers in Montana with a rate index of 100 (100 = the Montana market median), across 227 procedure codes.
2
Blue Cross Blue Shield has the highest median for only 4% of codes in Montana; Aetna leads with an index of 123 in the files analyzed.
3
Blue Cross Blue Shield's Montana rates sit 4% below its own national level, the 27th highest of its 51 states.
4
Largest premium over the Montana market: CPT 36465 (Njx noncmpnd sclrsnt 1 vein) at 147% of market; largest discount: CPT 91110 (Gi trc img intral esoph-ile) at 15%.
5
In Montana, BCBS rates come from 33 licensee file sets; the largest is BCBS MT (355 sampled providers).
How the four payers compare in Montana
Rate index: 100 = the state four-payer median for the same codes
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Aetna | 123 | 1 | 68% | 80 | |
| UnitedHealthcare | 114 | 2 | 69% | 323 | |
| Cigna | 100 | 3 | 13% | 367 | |
| Blue Cross Blue Shield | 100 | 3 | 4% | 409 |
Where Blue Cross Blue Shield pays most and least against the Montana market
Codes with the largest gap to the state median
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 36465 Njx noncmpnd sclrsnt 1 vein | $269 | $184 | +47% | 20 |
| 36482 Endoven ther chem adhes 1st | $394 | $277 | +43% | 20 |
| 90960 Esrd srv 4 visits p mo 20+ | $552 | $511 | +8% | 24 |
| 93229 Remote 30 day ecg tech supp | $1,301 | $1,257 | +4% | 20 |
| 43276 Ercp stent exchange w/dilate | $745 | $745 | +0% | 26 |
| 11302 Shave skin lesion 1.1-2.0 cm | $93 | $93 | +0% | 41 |
| 99350 Home/res vst est high mdm 60 | $290 | $290 | +0% | 85 |
| 99205 Office o/p new hi 60 min | $284 | $284 | +0% | 407 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 91110 Gi trc img intral esoph-ile | $174 | $1,152 | -85% | 27 |
| 93925 Lower extremity study | $58 | $379 | -85% | 42 |
| 77280 Ther rad simulaj field smpl | $59 | $354 | -83% | 38 |
| 93880 Extracranial bilat study | $59 | $300 | -80% | 185 |
| 92242 Fluorescein&icg angiography | $84 | $423 | -80% | 34 |
| 78452 Ht muscle image spect mult | $117 | $557 | -79% | 128 |
| 93308 Tte f-up or lmtd | $38 | $156 | -75% | 43 |
| 73502 X-ray exam hip uni 2-3 views | $17 | $65 | -74% | 132 |
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 Montana
File sets contributing rates; licensees are different companies
| Licensee file set | Sampled providers |
|---|---|
| BCBS MT | 355 |
| Blue Cross Blue Shield of Wyoming | 49 |
| Regence | 28 |
| Community Insurance Company | 19 |
| Premera | 15 |
| BCBS TX | 14 |
| HealthKeepers, Inc. | 10 |
| Healthy Alliance Life Insurance Company | 10 |
| BCBS NC | 9 |
| BCBS MN | 9 |
| Matthew Thornton Health Plan, Inc. | 8 |
| Wellmark | 6 |
| BCBS HI | 3 |
| BCBS KS | 3 |
| Blue Cross Blue Shield of North Dakota | 2 |
| BCBS OK | 2 |
| BCBS NJ (Horizon) | 2 |
| Anthem (Elevance) | 2 |
| Horizon Healthcare of New Jersey | 2 |
| BCBS MI | 1 |
| BCBS NM | 1 |
| BCBS VT | 1 |
| BCBS MA | 1 |
| BCBS TN | 1 |
| Compcare Health Services Insurance Corporation | 1 |
| BCBS MS | 1 |
| Carefirst BCBS | 1 |
| Blue Shield of California Life & Health Insurance Company | 1 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 1 |
| Blue Cross and Blue Shield of Nebraska | 1 |
| Excellus BCBS | 1 |
| HMO Missouri, Inc. | 1 |
| BS CA | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Montana?
Blue Cross Blue Shield ranks 3rd of 4 in Montana with an index of 100. It is highest on 4% of codes.
Are Blue Cross Blue Shield's Montana rates above or below its national level?
About 4% below.
Which procedure does Blue Cross Blue Shield pay most above market in Montana?
CPT 36465 (Njx noncmpnd sclrsnt 1 vein), at 147% of the Montana 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 Montana?
Compare your negotiated rates for these codes with Montana medians for each payer.