Commercial healthcare reimbursement in Delaware
How Delaware compares with the nation, by payer, specialty and procedure.
Delaware at a glance
What the data shows
Delaware ranks 45th of 51 states for commercial reimbursement, with an index of 87 (100 = national median) across 228 procedure codes; the South region averages 94.
Commercial rates in Delaware run a median 129% of Medicare.
UnitedHealthcare has the highest index in the state (108) and Aetna the lowest (87), a 21-point gap, in the files analyzed.
CPT 97110 (Therapeutic exercises) is the strongest relative to the national median (121% of it, a 21% premium); CPT 93297 (Rem interrog dev eval icpms) is furthest below (57% of the national median, 43% lower).
By specialty, Delaware is strongest for diagnostic radiology (ranks 28th of 51 states for that specialty) and weakest for ophthalmology (48th of 50).
Against Medicare, diagnostic radiology has the highest ratio in Delaware (146% of Medicare) and dermatology the lowest (92%).
Payer ranking in Delaware
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 108 | 1 | 228 | 379 | 211 | |
| Cigna | 100 | 2 | 194 | 392 | 249 | |
| Blue Cross Blue Shield | 87 | 3 | 115 | 170 | 177 | |
| Aetna | 87 | 4 | 219 | 349 | 271 |
Reimbursement index by specialty in Delaware
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Diagnostic radiology | 99 | 28 of 51 | 146% | 49 | 101 | |
| Orthopedic surgery | 93 | 34 of 51 | 137% | 39 | 59 | |
| Dermatology | 92 | 36 of 50 | 92% | 44 | 18 | |
| Urology | 87 | 42 of 50 | 131% | 37 | 29 | |
| Internal medicine | 80 | 44 of 51 | 97% | 25 | 108 | |
| Gastroenterology | 85 | 45 of 50 | 144% | 36 | 29 | |
| Cardiology | 81 | 47 of 51 | 122% | 38 | 72 | |
| Ophthalmology | 82 | 48 of 50 | 98% | 42 | 47 |
Specialty by payer in Delaware
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 92 | 67 | 92 | 68 |
| Dermatology | 106 | 77 | n/a | n/a |
| Ophthalmology | 85 | 80 | 79 | n/a |
| Cardiology | 81 | 72 | 87 | 64 |
| Orthopedic surgery | 91 | 94 | 97 | 107 |
| Diagnostic radiology | 136 | 71 | 96 | 85 |
| Urology | 116 | 60 | 79 | n/a |
| Gastroenterology | 95 | 70 | 79 | n/a |
Delaware compared with South region states
Procedures that pay most and least in Delaware vs the nation
Highest vs national
| Code | Delaware | National | Gap | Prov. |
|---|---|---|---|---|
| 97110 Therapeutic exercises | $38 | $31 | +21% | 58 |
| 76857 Us exam pelvic limited | $86 | $75 | +16% | 28 |
| 71275 Ct angiography chest | $534 | $462 | +16% | 98 |
| 70496 Ct angiography head | $523 | $457 | +15% | 98 |
| 70498 Ct angiography neck | $522 | $459 | +14% | 98 |
| 76775 Us exam abdo back wall lim | $103 | $92 | +12% | 28 |
| 72148 Mri lumbar spine w/o dye | $425 | $382 | +11% | 159 |
| 92250 Fundus photography w/i&r | $58 | $53 | +11% | 47 |
| 45388 Colonoscopy w/ablation | $543 | $492 | +10% | 29 |
| 74174 Cta abd&plvs w/contrast | $660 | $601 | +10% | 98 |
| 72141 Mri neck spine w/o dye | $425 | $390 | +9% | 100 |
| 73221 Mri joint upr extrem w/o dye | $425 | $399 | +7% | 159 |
| 73721 Mri jnt of lwr extre w/o dye | $425 | $399 | +7% | 159 |
| 70551 Mri brain stem w/o dye | $425 | $402 | +6% | 100 |
| 99202 Office o/p new sf 15 min | $73 | $70 | +5% | 18 |
Lowest vs national
| Code | Delaware | National | Gap | Prov. |
|---|---|---|---|---|
| 93297 Rem interrog dev eval icpms | $30 | $52 | -43% | 72 |
| 93298 Rem interrog dev eval scrms | $32 | $52 | -38% | 72 |
| 43251 Egd remove lesion snare | $288 | $425 | -32% | 29 |
| 46221 Ligation of hemorrhoid(s) | $236 | $346 | -32% | 29 |
| 43255 Egd control bleeding any | $313 | $459 | -32% | 29 |
| 96910 Photchmtx tar&uvb/ptrltm&uvb | $86 | $125 | -31% | 17 |
| 52601 Prostatectomy (turp) | $821 | $1,181 | -31% | 29 |
| 51700 Irrigation of bladder | $54 | $77 | -30% | 29 |
| 43248 Egd guide wire insertion | $260 | $364 | -29% | 29 |
| 52356 Cysto/uretero w/lithotripsy | $470 | $657 | -28% | 29 |
| 93016 Cv stress test supvj only | $24 | $34 | -28% | 72 |
| 43249 Esoph egd dilation <30 mm | $195 | $271 | -28% | 29 |
| 55874 Tprnl plmt biodegrdabl matrl | $187 | $257 | -27% | 29 |
| 96372 Ther/proph/diag inj sc/im | $17 | $24 | -27% | 107 |
| 93010 Electrocardiogram report | $9 | $13 | -27% | 72 |
Frequently asked questions
How do commercial reimbursement rates in Delaware compare with the rest of the country?
Delaware ranks 45th of 51 states with an index of 87, across 228 procedure codes. Median commercial rates run 129% of the Medicare rate.
Which payer has the highest rates in Delaware?
In the files we analyzed, UnitedHealthcare has the highest index (108) and Aetna the lowest (87). Each payer's figures describe the specific plans and networks in the files used, not its whole book of business.
Which specialty has the strongest rates in Delaware?
Diagnostic radiology ranks 28th of 51 states.
How many providers does this Delaware page cover?
463 sampled providers across 4 payers. The data comes from a random sample of providers, so counts describe the sample, not every provider in the state.
Which procedures differ most between Delaware and the national median?
CPT 97110 (Therapeutic exercises) is highest relative to the nation at 121% of the national median; CPT 93297 (Rem interrog dev eval icpms) is lowest at 57%.
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.
Benchmark your Delaware contracts
Compare your negotiated rates with these state medians by payer and specialty.