By JASON HINES

On August 1, 2025, Capital Women’s Care (CWC), one of the largest OB/GYN practices in the Mid-Atlantic region went out-of-network with UnitedHealthcare, affecting tens of thousands of women across Maryland, Virginia, Pennsylvania, and Washington D.C. The contract dispute between Capital Women’s Care (CWC) and UnitedHealthcare offers a fascinating case study in how price transparency data can illuminate the real dynamics behind these high-stakes negotiations.

The Public Battle

Capital Women’s Care, with more than 250 physicians and healthcare professionals, confirmed that its agreement with UnitedHealthcare would lapse despite ongoing negotiations. The practice urged patients to contact UHC to voice their concerns about losing access to their providers.

UnitedHealthcare fired back with detailed public claims on their website, alleging that CWC “refused to move off its demands for double-digit price hikes” and is “significantly higher cost today compared to peer providers throughout Maryland and Virginia”. UHC provided specific examples, claiming that a vaginal delivery from CWC would cost “more than 120% higher – or over $2,600 more – than the average cost of other OB/GYN providers”.

But what does the actual price transparency data reveal about these competing claims?

What the Transparency Data Shows

Using Capital Women’s Care’s negotiated rates from UnitedHealthcare’s own machine-readable files, we analyzed a sample of common OB/GYN procedures from Maryland rate data. While this represents only a subset of all procedures and focuses specifically on Maryland rates, it provides valuable insights into the real payment dynamics between these organizations. The data paints a more nuanced picture than either party’s public statements suggest.

Data Methodology Note: Our analysis examined negotiated rates for Capital Women’s Care from publicly available machine-readable files, focusing on Maryland providers and filtering out statistical outliers (rates below 50% or above 500% of Medicare). We analyzed rates for both UnitedHealthcare and CareFirst across three common OB/GYN procedures where both payers had sufficient data.

CWC’s Rate Position vs Other Payers

Our analysis of three common OB/GYN procedures in Maryland reveals that CWC’s rates with UnitedHealthcare were actually quite competitive compared to other major payers:

For the three procedures where both UHC and CareFirst have negotiated rates with CWC:

• CPT 56515 (Vulvar Lesion Destruction): UHC paid $401 vs CareFirst’s $617 (53.9% difference)
• CPT 57288 (Sling Operation): UHC paid $1,163 vs CareFirst’s $1,254 (7.8% difference)
• CPT 58558 (Hysteroscopy): UHC paid $2,294 vs CareFirst’s $2,318 (1.0% difference)

This sample data suggests UnitedHealthcare was already getting favorable rates from CWC compared to other major payers, calling into question UHC’s claims about CWC being “significantly higher cost.”

The Medicare Benchmark Reality

Both UHC and CareFirst were paying CWC rates well above Medicare in our sample:

• UnitedHealthcare: 143-175% of Medicare rates
• CareFirst: 166-220% of Medicare rates

While CareFirst paid higher rates, UnitedHealthcare’s rates were still substantial premiums over government reimbursement, suggesting the “double-digit increases” CWC requested may have been attempts to align with market rates other payers were willing to pay.