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
What the data shows
Aetna ranks 3rd of 4 payers in Arizona with a rate index of 91 (100 = the Arizona market median), across 228 procedure codes.
Aetna has the highest median for only 3% of codes in Arizona; UnitedHealthcare leads with an index of 115 in the files analyzed.
Aetna's Arizona rates sit 12% below its own national level, the 43rd highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 115 | 1 | 64% | 699 | |
| Cigna | 102 | 2 | 29% | 698 | |
| Aetna | 91 | 3 | 3% | 719 | |
| Blue Cross Blue Shield | 82 | 4 | 5% | 479 |
Where Aetna pays most and least against the Arizona market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 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
- 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 Arizona?
Compare your negotiated rates for these codes with Arizona medians for each payer.