Office visit, established patient (30-39 min) cost in DE
What a office visit, established patient (30-39 min) costs at DE hospitals — and the fair price to aim for.
Typical commercial prices here are +17% above the fair benchmark (1.17×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
This hospital prices routine shoppable procedures at 2.5× Medicare (median 1.71× Fair BaseRate) while upper-quartile commercial rates jump +44% to 2.47× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.87× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 23% of shoppable procedures (85/100 Cash Honesty)
- CMS clinical safety score (59/100 safety score) with 65% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (40.6% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.17× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 1.71× Fair BaseRate (2.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.47×) jump +44% above the median procedure ratio (Q50 1.71×)
- Unnegotiated chargemaster list prices average 12.9× Medicare (17¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, DE hospitals charge about the fair price for this. how we calculate the BaseRate →
Compared with the rest of the country, DE’s fair BaseRate ($146) is above the national fair price of $123.
Cheapest DE hospitals for a office visit, established patient (30-39 min)
- St Francis Hospital · Wilmington $92
- Tidalhealth Nanticoke, Inc. · Seaford $108
- PAM Health Rehabilitation Hospital of Georgetown · Georgetown $123
- PAM Rehabilitation Hospital of Dover · Dover $143
- Nemours Children's Hospital, Delaware · Wilmington $144
- Bayhealth Medical Center, Kent Campus · Dover $159
- Bayhealth Hospital, Sussex Campus · Milford $159
- Beebe Medical Center · Lewes $159
Audit a Bill or Quote at DE Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $126
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $126).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask DE Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $146 Fair BaseRate ($85 Medicare)
Your bill ($346) is $200 above the denoised Fair BaseRate ($146) and 4.1× the $85 Medicare rate.