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
What the data shows
Aetna ranks 1st of 4 payers in Alabama with a rate index of 100 (100 = the Alabama market median), across 228 procedure codes.
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.
Aetna's Alabama rates sit 11% above its own national level, the 10th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Blue Cross Blue Shield | 100 | 1 | 33% | 852 | |
| Aetna | 100 | 1 | 31% | 847 | |
| UnitedHealthcare | 96 | 3 | 31% | 719 | |
| Cigna | 86 | 4 | 5% | 837 |
Where Aetna pays most and least against the Alabama market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
Highest states
| State | Index | Prov. | |
|---|---|---|---|
| Alaska | 306 | 211 | |
| Idaho | 152 | 491 | |
| Washington | 142 | 708 | |
| Mississippi | 138 | 608 | |
| Montana | 136 | 80 |
Lowest states
| State | Index | Prov. | |
|---|---|---|---|
| Indiana | 80 | 698 | |
| South Dakota | 82 | 147 | |
| Florida | 82 | 758 | |
| Minnesota | 84 | 774 | |
| North Dakota | 85 | 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
- 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.
Is your Aetna contract at market in Alabama?
Compare your negotiated rates for these codes with Alabama medians for each payer.