Aetna · Alabama · commercial in-network

Aetna negotiated rates in Alabama

How Aetna's Alabama rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.

Aetna in Alabama at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
100
0% above the Alabama median
Rank in state
1 of 4
BCBS 100 · Aetna 100 · UHC 96 · Cigna 86
vs own national
111
Aetna's level vs its national median
Codes where highest
31%
of 228 codes
847 sampled providers648 TINs228 codesMedian 137% of Medicare · method

What the data shows

Generated from Alabama and Aetna data only
1

Aetna ranks 1st of 4 payers in Alabama with a rate index of 100 (100 = the Alabama market median), across 228 procedure codes.

2

Aetna has the highest median for only 31% of codes in Alabama; Blue Cross Blue Shield leads with an index of 100 in the files analyzed.

3

Aetna's Alabama rates sit 11% above its own national level, the 10th highest of its 51 states.

4

Largest premium over the Alabama market: CPT 93298 (Rem interrog dev eval scrms) at 257% of market; largest discount: CPT 76512 (Oph us dx b-scan) at 63%.

How the four payers compare in Alabama

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
Blue Cross Blue Shield1001
100
33%852
Aetna1001
100
31%847
UnitedHealthcare963
96
31%719
Cigna864
86
5%837

Where Aetna pays most and least against the Alabama market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
93298
Rem interrog dev eval scrms
$174$68+157%117
93297
Rem interrog dev eval icpms
$106$53+99%103
66821
After cataract laser surgery
$593$319+86%97
65820
Goniotomy
$1,557$892+75%88
51729
Cystometrogram w/vp&up
$676$417+62%102
68761
Close tear duct opening
$225$141+60%94
45390
Colonoscopy w/resection
$665$418+59%98
93280
Pm device progr eval dual
$137$88+56%118

Furthest below market

CodeAetnaMarketGapProv.
76512
Oph us dx b-scan
$62$99-37%93
92136
Ophthalmic biometry
$49$76-36%98
17004
Destroy premal lesions 15/>
$94$139-32%116
99454
Rem mntr physiol param 16-30
$34$49-32%175
13152
Cmplx rpr e/n/e/l 2.6-7.5 cm
$319$466-32%112
13132
Cmplx rpr f/c/c/m/n/ax/g/h/f
$289$414-30%113
92250
Fundus photography w/i&r
$38$53-28%96
99202
Office o/p new sf 15 min
$38$53-28%116

Where Aetna pays above and below its national level

Index vs the payer's own national median (100 = national)

Highest states

StateIndexProv.
Alaska306
211
Idaho152
491
Washington142
708
Mississippi138
608
Montana136
80

Lowest states

StateIndexProv.
Indiana80
698
South Dakota82
147
Florida82
758
Minnesota84
774
North Dakota85
211

Frequently asked questions

Does Aetna pay more or less than the other payers in Alabama?

Aetna ranks 1st of 4 in Alabama with an index of 100. It is highest on 31% of codes.

Are Aetna's Alabama rates above or below its national level?

About 11% above.

Which procedure does Aetna pay most above market in Alabama?

CPT 93298 (Rem interrog dev eval scrms), at 257% of the Alabama median.

Methodology

How these numbers are calculated
  • 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.

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