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Regional Payer (District of Columbia, Maryland, Virginia)Blue Cross Blue Shield (BCBS) family

Payer price transparency data

Care First

Care First is a regional (District of Columbia, Maryland, Virginia) health insurer, part of the Blue Cross Blue Shield (BCBS) family. They report 7.4K insurance plans covering 100K providers across 17K billing codes.

Source: public Transparency in Coverage filesRefreshed monthly, latest September 202619 monthly releases tracked

Monthly release

7.4K

Plans

100K

Providers (NPIs)

XX% vs prior month

20K

Tax IDs

XX% vs prior month

17K

Billing codes

XX% vs prior month

20M

Rate rows

XX% vs prior month

September 2026 release

What's in Care First's data

A profile of the machine-readable files Care First publishes, after PayerPrice parses and normalizes them.

Billing code types

Distinct codes and rate rows by code system

CodesRows
  • CPT10K19M94%
  • HCPCS4.5K1.2M5.9%
  • CDT83076K0.4%
  • RC1402.2K<0.1%
  • MS-DRG780620<0.1%
  • LOCAL1230<0.1%

Billing class

Professional vs. institutional rate rows

  • Professional20M100%

Negotiation arrangement

How each rate is expressed

  • Negotiated20M100%
  • Per Diem1.5K<0.1%

Plan identifiers

HIOS IDs mark individual and small-group plans; EINs mark employer plans

  • HIOS ID4305.9%
  • EIN7K94%

Providers by type

Distinct NPIs by entity type

  • Individual (Type 1)85K83%
  • Organization (Type 2)17K17%

Tax IDs by type

How provider groups are identified

  • EIN19K94%
  • NPI (Individual)1.2K6.2%
  • NPI (Organization)530.3%

Top states

States with the most providers in network

  • Maryland55K
  • Virginia21K
  • District of Columbia8K
  • Pennsylvania2.6K
  • Delaware1.8K
  • Florida1.6K

Top specialties

Provider taxonomies with the most NPIs

  • Clinical Social Worker9K
  • Physical Therapist6.2K
  • Family Nurse Practitioner5.5K
  • Professional Counselor5.1K
  • Internal Medicine Physician4.8K
  • Mental Health Counselor4.1K

These are the files. Want the rates inside them?

Look up Care First's negotiated rates by provider, TIN, billing code and plan.

Month-over-month history

Track how network size and rate volume change with each monthly release.

MonthPlansNPIsTax IDsBilling codesRate rows
September 20267.4K100K20K17K20M
August 20267.4K100K20K16K7.9M
July 20267.5K86K19K16K6.3M
June 2026————
May 2026————

Data quality scorecard

5/6Good

This payer scores 5/6 on data quality (Good). Areas that don't meet the threshold: professional & institutional rates.

Evaluated on the September 2026 release.

  • Professional & Institutional Rates

    Data is missing professional and/or institutional billing class rates

  • Valid Tax IDs

    More than 80% of Tax IDs are EIN or NPI (Organization) type

  • HIOS Plan

    Data includes at least one HIOS-identified plan

  • Low Derived/Percentage Rates

    Less than 10% of negotiation entries are derived or percentage type

  • Standard Code Coverage

    Sufficient CPT and HCPCS code coverage with low proportion of LOCAL entries

  • Common Taxonomies

    NPIs in the dataset cover at least 50 distinct provider taxonomies

How the score works

Each monthly release is checked against six criteria. 5–6 passing criteria rate Good, 3–4 rate Acceptable, and 0–2 rate Poor.

Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.

Access the data

Care First's negotiated rates, in the tools your team already uses

PayerPrice turns raw transparency files into one clean, normalized dataset across 180+ payers, refreshed every month. Pick how you want to work with it.

UI

Web app

Search Care First's rates by code, provider or market and export the results. No setup required.

Start free trial
API

REST API

Pull negotiated rates, providers and benchmarks into your own products and pipelines.

Explore the API
SQL

Snowflake & Databricks

Query the full normalized dataset with SQL or PySpark, shared directly into your warehouse.

See data sharing
AI

MCP server

Ask Claude, Cursor or your own agents questions like "What does Care First pay for CPT 99213 near me?"

Read the MCP docs
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Frequently asked questions

About Care First's price transparency data.

What price transparency data does Care First publish?

Care First's September 2026 Transparency in Coverage files list 7.4K plans, 100K providers (NPIs), 20K tax IDs and 17K billing codes, for 20M negotiated rate rows in total.

Which states does Care First's network cover?

Care First's files include providers in 51 states. The states with the most in-network providers are Maryland, Virginia, District of Columbia, Pennsylvania, Delaware.

How often is Care First's data updated?

Payers must post updated machine-readable files every month. PayerPrice processes Care First's files monthly; the latest processed release is September 2026, and 19 monthly releases are available.

What is the Transparency in Coverage rule?

Since July 2022, the federal Transparency in Coverage rule has required most group health plans and health insurers to publish machine-readable files of their in-network negotiated rates and out-of-network allowed amounts, updated monthly. These files are the source for the data on this page.

How can I access Care First's negotiated rates?

Start a free PayerPrice trial to search Care First's rates in the web app, or book a demo to get the full dataset through the REST API, SQL in Snowflake or Databricks, or AI assistants through the PayerPrice MCP server.