Commercial healthcare reimbursement in Maryland
How Maryland compares with the nation, by payer, specialty and procedure.
Maryland at a glance
What the data shows
Maryland ranks 46th of 51 states for commercial reimbursement, with an index of 86 (100 = national median) across 228 procedure codes; the South region averages 94.
Commercial rates in Maryland run a median 129% of Medicare.
UnitedHealthcare has the highest index in the state (131) and Blue Cross Blue Shield the lowest (74), a 57-point gap, in the files analyzed.
CPT 97110 (Therapeutic exercises) is the strongest relative to the national median (110% of it, a 10% premium); CPT 52224 (Cystoscopy and treatment) is furthest below (60% of the national median, 40% lower).
By specialty, Maryland is strongest for orthopedic surgery (ranks 26th of 51 states for that specialty) and weakest for dermatology (46th of 50).
Against Medicare, urology has the highest ratio in Maryland (155% of Medicare) and dermatology the lowest (77%).
Payer ranking in Maryland
| Payer | Index | Rank | Level | Codes | Providers | TINs |
|---|---|---|---|---|---|---|
| UnitedHealthcare | 131 | 1 | 228 | 606 | 503 | |
| Cigna | 110 | 2 | 227 | 723 | 528 | |
| Aetna | 101 | 3 | 228 | 645 | 548 | |
| Blue Cross Blue Shield | 74 | 4 | 228 | 758 | 745 |
Reimbursement index by specialty in Maryland
| Specialty | Index | Rank among states | % of Medicare | Level | Codes | Providers |
|---|---|---|---|---|---|---|
| Orthopedic surgery | 99 | 26 of 51 | 149% | 39 | 106 | |
| Urology | 96 | 29 of 50 | 155% | 37 | 104 | |
| Cardiology | 90 | 37 of 51 | 118% | 38 | 112 | |
| Gastroenterology | 89 | 41 of 50 | 147% | 36 | 110 | |
| Diagnostic radiology | 86 | 45 of 51 | 129% | 49 | 108 | |
| Internal medicine | 80 | 45 of 51 | 90% | 25 | 94 | |
| Ophthalmology | 85 | 45 of 50 | 100% | 42 | 106 | |
| Dermatology | 80 | 46 of 50 | 77% | 44 | 109 |
Specialty by payer in Maryland
| Specialty | UHC | Aetna | Cigna | BCBS |
|---|---|---|---|---|
| Internal medicine | 110 | 73 | 107 | 61 |
| Dermatology | 102 | 70 | 82 | 69 |
| Ophthalmology | 90 | 95 | 83 | 70 |
| Cardiology | 109 | 108 | 113 | 62 |
| Orthopedic surgery | 112 | 103 | 110 | 65 |
| Diagnostic radiology | 120 | 84 | 95 | 65 |
| Urology | 142 | 94 | 108 | 53 |
| Gastroenterology | 116 | 87 | 99 | 57 |
Maryland compared with South region states
Procedures that pay most and least in Maryland vs the nation
Highest vs national
| Code | Maryland | National | Gap | Prov. |
|---|---|---|---|---|
| 97110 Therapeutic exercises | $35 | $31 | +10% | 105 |
| 93297 Rem interrog dev eval icpms | $56 | $52 | +8% | 111 |
| 29848 Wrist endoscopy/surgery | $856 | $817 | +5% | 105 |
| 76872 Us transrectal | $196 | $188 | +4% | 102 |
| 22612 Arthrd pst tq 1ntrspc lumbar | $2,623 | $2,557 | +3% | 105 |
| 64721 Carpal tunnel surgery | $718 | $700 | +3% | 106 |
| 51729 Cystometrogram w/vp&up | $568 | $554 | +2% | 101 |
| 29827 Sho arthrs srg rt8tr cuf rpr | $1,736 | $1,701 | +2% | 106 |
| 27236 Treat thigh fracture | $1,957 | $1,918 | +2% | 105 |
| 52356 Cysto/uretero w/lithotripsy | $670 | $657 | +2% | 103 |
| 63047 Lam facetec & foramot lumbar | $1,827 | $1,796 | +2% | 105 |
| 27245 Treat thigh fracture | $2,024 | $1,994 | +1% | 105 |
| 27487 Revise/replace knee joint | $2,875 | $2,840 | +1% | 105 |
| 27447 Total knee arthroplasty | $2,210 | $2,190 | +1% | 106 |
| 22633 Arthrd cmbn 1ntrspc lumbar | $2,996 | $2,991 | +0% | 105 |
Lowest vs national
| Code | Maryland | National | Gap | Prov. |
|---|---|---|---|---|
| 52224 Cystoscopy and treatment | $273 | $459 | -40% | 102 |
| 76512 Oph us dx b-scan | $47 | $70 | -33% | 105 |
| 11301 Shave skin lesion 0.6-1.0 cm | $58 | $85 | -32% | 108 |
| 99350 Home/res vst est high mdm 60 | $169 | $247 | -32% | 94 |
| 76857 Us exam pelvic limited | $51 | $75 | -31% | 102 |
| 11104 Punch bx skin single lesion | $56 | $81 | -30% | 109 |
| 11102 Tangntl bx skin single les | $45 | $65 | -30% | 109 |
| 93016 Cv stress test supvj only | $24 | $34 | -30% | 111 |
| 51700 Irrigation of bladder | $55 | $77 | -29% | 103 |
| 51702 Insert temp bladder cath | $44 | $61 | -28% | 103 |
| 11302 Shave skin lesion 1.1-2.0 cm | $71 | $98 | -28% | 109 |
| 93312 Echo transesophageal | $284 | $387 | -27% | 112 |
| 93308 Tte f-up or lmtd | $114 | $155 | -27% | 112 |
| 17311 Mohs 1 stage h/n/hf/g | $426 | $577 | -26% | 108 |
| 43237 Endoscopic us exam esoph | $235 | $318 | -26% | 109 |
Frequently asked questions
How do commercial reimbursement rates in Maryland compare with the rest of the country?
Maryland ranks 46th of 51 states with an index of 86, across 228 procedure codes. Median commercial rates run 129% of the Medicare rate.
Which payer has the highest rates in Maryland?
In the files we analyzed, UnitedHealthcare has the highest index (131) and Blue Cross Blue Shield the lowest (74). 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 Maryland?
Orthopedic surgery ranks 26th of 51 states.
How many providers does this Maryland page cover?
849 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 Maryland and the national median?
CPT 97110 (Therapeutic exercises) is highest relative to the nation at 110% of the national median; CPT 52224 (Cystoscopy and treatment) is lowest at 60%.
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 Maryland contracts
Compare your negotiated rates with these state medians by payer and specialty.