Blue Cross Blue Shield negotiated rates in Rhode Island
How Blue Cross Blue Shield's Rhode Island rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Rhode Island at a glance
What the data shows
Blue Cross Blue Shield ranks 3rd of 4 payers in Rhode Island with a rate index of 90 (100 = the Rhode Island market median), across 228 procedure codes.
Blue Cross Blue Shield has the highest median for only 1% of codes in Rhode Island; UnitedHealthcare leads with an index of 129 in the files analyzed.
Blue Cross Blue Shield's Rhode Island rates sit 13% below its own national level, the 36th highest of its 51 states.
Largest premium over the Rhode Island market: CPT 92242 (Fluorescein&icg angiography) at 113% of market; largest discount: CPT 99497 (Advncd care plan 30 min) at 11%.
In Rhode Island, BCBS rates come from 31 licensee file sets; the largest is BCBS RI (516 sampled providers).
How the four payers compare in Rhode Island
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 129 | 1 | 60% | 468 | |
| Cigna | 110 | 2 | 26% | 562 | |
| Blue Cross Blue Shield | 90 | 3 | 1% | 581 | |
| Aetna | 87 | 4 | 12% | 422 |
Where Blue Cross Blue Shield pays most and least against the Rhode Island market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 92242 Fluorescein&icg angiography | $326 | $289 | +13% | 59 |
| 33285 Insj subq car rhythm mntr | $137 | $122 | +12% | 85 |
| 93297 Rem interrog dev eval icpms | $58 | $52 | +12% | 86 |
| 26055 Incise finger tendon sheath | $704 | $639 | +10% | 88 |
| 88312 Special stains group 1 | $112 | $103 | +9% | 108 |
| 29848 Wrist endoscopy/surgery | $982 | $915 | +7% | 88 |
| 63047 Lam facetec & foramot lumbar | $1,999 | $1,893 | +6% | 88 |
| 64721 Carpal tunnel surgery | $793 | $753 | +5% | 88 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 99497 Advncd care plan 30 min | $10 | $91 | -89% | 77 |
| 93458 L hrt artery/ventricle angio | $792 | $1,675 | -53% | 85 |
| 51720 Treatment of bladder lesion | $62 | $111 | -44% | 38 |
| 93000 Electrocardiogram complete | $14 | $25 | -43% | 568 |
| 64566 Neuroeltrd stim post tibial | $39 | $66 | -41% | 38 |
| 65778 Cover eye w/membrane | $52 | $86 | -40% | 59 |
| 93016 Cv stress test supvj only | $25 | $39 | -37% | 86 |
| 93306 Tte w/doppler complete | $233 | $367 | -36% | 167 |
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 Rhode Island
| Licensee file set | Sampled providers |
|---|---|
| BCBS RI | 516 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 125 |
| BCBS MA | 111 |
| Community Insurance Company | 63 |
| Matthew Thornton Health Plan, Inc. | 34 |
| HealthKeepers, Inc. | 25 |
| Compcare Health Services Insurance Corporation | 14 |
| Anthem (Elevance) | 14 |
| Blue Cross and Blue Shield of Massachusetts, Inc. | 9 |
| BCBS TX | 9 |
| BCBS NC | 8 |
| BCBS IL | 7 |
| Carefirst BCBS | 6 |
| Healthy Alliance Life Insurance Company | 6 |
| BCBS HI | 4 |
| BCBS NJ (Horizon) | 4 |
| BCBS MI | 4 |
| Blue Shield of California Life & Health Insurance Company | 4 |
| Horizon Healthcare of New Jersey | 4 |
| Excellus BCBS | 3 |
| Capital BC | 3 |
| BS CA | 3 |
| Capital BlueCross | 3 |
| BCBS AL | 2 |
| BCBS MN | 2 |
| HMO Colorado, Inc. | 2 |
| Wellmark | 2 |
| BCBS VT | 2 |
| BCBS TN | 2 |
| Premera | 1 |
| Blue Cross Blue Shield of North Dakota | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Rhode Island?
Blue Cross Blue Shield ranks 3rd of 4 in Rhode Island with an index of 90. It is highest on 1% of codes.
Are Blue Cross Blue Shield's Rhode Island rates above or below its national level?
About 13% below.
Which procedure does Blue Cross Blue Shield pay most above market in Rhode Island?
CPT 92242 (Fluorescein&icg angiography), at 113% of the Rhode Island 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 Rhode Island?
Compare your negotiated rates for these codes with Rhode Island medians for each payer.