Blue Cross Blue Shield negotiated rates in Delaware
How Blue Cross Blue Shield's Delaware rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Blue Cross Blue Shield in Delaware at a glance
What the data shows
Blue Cross Blue Shield ranks 3rd of 4 payers in Delaware with a rate index of 87 (100 = the Delaware market median), across 115 procedure codes.
Blue Cross Blue Shield has the highest median for only 10% of codes in Delaware; UnitedHealthcare leads with an index of 108 in the files analyzed.
Blue Cross Blue Shield's Delaware rates sit 18% below its own national level, the 41st highest of its 51 states.
Largest premium over the Delaware market: CPT 93297 (Rem interrog dev eval icpms) at 203% of market; largest discount: CPT 93308 (Tte f-up or lmtd) at 20%.
In Delaware, BCBS rates come from 29 licensee file sets; the largest is Carefirst BCBS (76 sampled providers).
How the four payers compare in Delaware
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 108 | 1 | 70% | 379 | |
| Cigna | 100 | 2 | 16% | 392 | |
| Blue Cross Blue Shield | 87 | 3 | 10% | 170 | |
| Aetna | 87 | 4 | 12% | 349 |
Where Blue Cross Blue Shield pays most and least against the Delaware market
Highest above market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93297 Rem interrog dev eval icpms | $60 | $30 | +103% | 22 |
| 73564 X-ray exam knee 4 or more | $77 | $56 | +39% | 19 |
| 73610 X-ray exam of ankle | $59 | $43 | +38% | 19 |
| 73562 X-ray exam of knee 3 | $66 | $49 | +37% | 19 |
| 73630 X-ray exam of foot | $56 | $41 | +35% | 19 |
| 73030 X-ray exam of shoulder | $54 | $41 | +33% | 19 |
| 92012 Intrm oph exam est patient | $80 | $64 | +24% | 21 |
| 64721 Carpal tunnel surgery | $820 | $663 | +24% | 19 |
Furthest below market
| Code | BCBS | Market | Gap | Prov. |
|---|---|---|---|---|
| 93308 Tte f-up or lmtd | $23 | $118 | -80% | 22 |
| 93312 Echo transesophageal | $134 | $315 | -58% | 22 |
| 93280 Pm device progr eval dual | $34 | $79 | -57% | 22 |
| 93298 Rem interrog dev eval scrms | $19 | $32 | -42% | 22 |
| 75574 Ct angio hrt w/3d image | $281 | $487 | -42% | 22 |
| 93296 Rem interrog evl pm/ids | $21 | $35 | -41% | 22 |
| 99495 Transj care mgmt mod f2f 14d | $119 | $192 | -38% | 40 |
| 99496 Transj care mgmt high f2f 7d | $170 | $270 | -37% | 40 |
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 Delaware
| Licensee file set | Sampled providers |
|---|---|
| Carefirst BCBS | 76 |
| Community Insurance Company | 51 |
| BCBS NJ (Horizon) | 43 |
| Horizon Healthcare of New Jersey | 43 |
| HealthKeepers, Inc. | 20 |
| BCBS TX | 8 |
| Anthem (Elevance) | 7 |
| Capital BC | 7 |
| Capital BlueCross | 7 |
| Healthy Alliance Life Insurance Company | 5 |
| Matthew Thornton Health Plan, Inc. | 4 |
| BCBS IL | 4 |
| Blue Shield of California Life & Health Insurance Company | 3 |
| Wellmark | 3 |
| BCBS RI | 3 |
| BCBS NC | 3 |
| BCBS TN | 3 |
| BS CA | 3 |
| Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. | 2 |
| BCBS NM | 2 |
| Compcare Health Services Insurance Corporation | 2 |
| BCBS MN | 2 |
| BCBS MA | 2 |
| Blue Cross Blue Shield of North Dakota | 1 |
| BCBS OK | 1 |
| BCBS KS | 1 |
| Premera | 1 |
| BCBS MI | 1 |
| BCBS MS | 1 |
Frequently asked questions
Does Blue Cross Blue Shield pay more or less than the other payers in Delaware?
Blue Cross Blue Shield ranks 3rd of 4 in Delaware with an index of 87. It is highest on 10% of codes.
Are Blue Cross Blue Shield's Delaware rates above or below its national level?
About 18% below.
Which procedure does Blue Cross Blue Shield pay most above market in Delaware?
CPT 93297 (Rem interrog dev eval icpms), at 203% of the Delaware 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 Delaware?
Compare your negotiated rates for these codes with Delaware medians for each payer.