Aetna negotiated rates in California
How Aetna's California rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in California at a glance
What the data shows
Aetna ranks 4th of 4 payers in California with a rate index of 84 (100 = the California market median), across 228 procedure codes.
Aetna has the highest median for only 2% of codes in California; UnitedHealthcare leads with an index of 126 in the files analyzed.
Aetna's California rates sit 3% below its own national level, the 32nd highest of its 51 states.
Largest premium over the California market: CPT 88342 (Imhchem/imcytchm 1st antb) at 113% of market; largest discount: CPT 51702 (Insert temp bladder cath) at 45%.
How the four payers compare in California
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 126 | 1 | 58% | 658 | |
| Cigna | 112 | 2 | 34% | 648 | |
| Blue Cross Blue Shield | 96 | 3 | 6% | 807 | |
| Aetna | 84 | 4 | 2% | 566 |
Where Aetna pays most and least against the California market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 88342 Imhchem/imcytchm 1st antb | $113 | $100 | +13% | 76 |
| 72148 Mri lumbar spine w/o dye | $475 | $421 | +13% | 133 |
| 88312 Special stains group 1 | $118 | $107 | +11% | 148 |
| 92235 Fluorescein angrph mltiframe | $147 | $134 | +10% | 80 |
| 92083 Extended visual field xm | $88 | $82 | +8% | 83 |
| 73721 Mri jnt of lwr extre w/o dye | $475 | $443 | +7% | 133 |
| 88305 Tissue exam by pathologist | $107 | $100 | +7% | 149 |
| 73221 Mri joint upr extrem w/o dye | $475 | $445 | +7% | 133 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 51702 Insert temp bladder cath | $36 | $79 | -55% | 57 |
| 52648 Laser surgery of prostate | $813 | $1,748 | -54% | 45 |
| 64566 Neuroeltrd stim post tibial | $34 | $74 | -53% | 55 |
| 52224 Cystoscopy and treatment | $217 | $440 | -51% | 53 |
| 52332 Cystoscopy and treatment | $198 | $374 | -47% | 57 |
| 99426 Prin care mgmt staff 1st 30 | $49 | $89 | -45% | 49 |
| 11104 Punch bx skin single lesion | $55 | $96 | -43% | 73 |
| 11102 Tangntl bx skin single les | $44 | $77 | -43% | 73 |
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 California?
Aetna ranks 4th of 4 in California with an index of 84. It is highest on 2% of codes.
Are Aetna's California rates above or below its national level?
About 3% below.
Which procedure does Aetna pay most above market in California?
CPT 88342 (Imhchem/imcytchm 1st antb), at 113% of the California 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 California?
Compare your negotiated rates for these codes with California medians for each payer.