Aetna · Arizona · commercial in-network

Aetna negotiated rates in Arizona

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

Aetna in Arizona at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
91
9% below the Arizona median
Rank in state
3 of 4
UHC 115 · Cigna 102 · Aetna 91 · BCBS 82
vs own national
88
Aetna's level vs its national median
Codes where highest
3%
of 228 codes
719 sampled providers697 TINs228 codesMedian 107% of Medicare · method

What the data shows

Generated from Arizona and Aetna data only
1

Aetna ranks 3rd of 4 payers in Arizona with a rate index of 91 (100 = the Arizona market median), across 228 procedure codes.

2

Aetna has the highest median for only 3% of codes in Arizona; UnitedHealthcare leads with an index of 115 in the files analyzed.

3

Aetna's Arizona rates sit 12% below its own national level, the 43rd highest of its 51 states.

4

Largest premium over the Arizona market: CPT 68761 (Close tear duct opening) at 120% of market; largest discount: CPT 99426 (Prin care mgmt staff 1st 30) at 53%.

How the four payers compare in Arizona

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1151
115
64%699
Cigna1022
102
29%698
Aetna913
91
3%719
Blue Cross Blue Shield824
82
5%479

Where Aetna pays most and least against the Arizona market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
68761
Close tear duct opening
$150$125+20%85
88313
Special stains group 2
$60$52+15%60
67028
Injection eye drug
$118$107+10%85
96413
Chemo iv infusion 1 hr
$217$200+9%58
66821
After cataract laser surgery
$345$323+7%90
43246
Egd place gastrostomy tube
$363$341+6%70
65820
Goniotomy
$848$797+6%77
17282
Dstr mal ls f/e/e/n/l/m1.1-2
$147$141+4%81

Furthest below market

CodeAetnaMarketGapProv.
99426
Prin care mgmt staff 1st 30
$36$68-47%27
64566
Neuroeltrd stim post tibial
$35$65-46%43
52224
Cystoscopy and treatment
$236$403-41%44
99457
Rpm tx mgmt 1st 20 min
$23$39-41%103
52648
Laser surgery of prostate
$856$1,445-41%42
99454
Rem mntr physiol param 16-30
$34$56-40%98
93296
Rem interrog evl pm/ids
$19$30-39%82
52000
Cystourethroscopy
$121$197-38%84

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 Arizona?

Aetna ranks 3rd of 4 in Arizona with an index of 91. It is highest on 3% of codes.

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

About 12% below.

Which procedure does Aetna pay most above market in Arizona?

CPT 68761 (Close tear duct opening), at 120% of the Arizona 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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