Aetna · Colorado · commercial in-network

Aetna negotiated rates in Colorado

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

Aetna in Colorado at a glance

Across 227 procedure codes for 8 specialties
Rate index vs state market
82
18% below the Colorado median
Rank in state
4 of 4
UHC 113 · BCBS 100 · Cigna 94 · Aetna 82
vs own national
105
Aetna's level vs its national median
Codes where highest
1%
of 227 codes
717 sampled providers479 TINs227 codesMedian 138% of Medicare · method

What the data shows

Generated from Colorado and Aetna data only
1

Aetna ranks 4th of 4 payers in Colorado with a rate index of 82 (100 = the Colorado market median), across 227 procedure codes.

2

Aetna has the highest median for only 1% of codes in Colorado; UnitedHealthcare leads with an index of 113 in the files analyzed.

3

Aetna's Colorado rates sit 5% above its own national level, the 17th highest of its 51 states.

4

Largest premium over the Colorado market: CPT 93298 (Rem interrog dev eval scrms) at 142% of market; largest discount: CPT 99454 (Rem mntr physiol param 16-30) at 49%.

How the four payers compare in Colorado

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1131
113
74%749
Blue Cross Blue Shield1002
100
22%796
Cigna943
94
3%752
Aetna824
82
1%717

Where Aetna pays most and least against the Colorado market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
93298
Rem interrog dev eval scrms
$113$79+42%91
88312
Special stains group 1
$124$98+27%139
88305
Tissue exam by pathologist
$88$70+25%149
88313
Special stains group 2
$98$85+15%79
43259
Egd us exam duodenum/jejunum
$406$380+7%45
88342
Imhchem/imcytchm 1st antb
$93$89+5%63
97110
Therapeutic exercises
$39$37+4%71
92235
Fluorescein angrph mltiframe
$177$173+2%64

Furthest below market

CodeAetnaMarketGapProv.
99454
Rem mntr physiol param 16-30
$41$84-51%78
99350
Home/res vst est high mdm 60
$140$275-49%22
99349
Home/res vst est mod mdm 40
$104$193-46%26
99426
Prin care mgmt staff 1st 30
$48$88-45%29
99457
Rpm tx mgmt 1st 20 min
$32$56-44%84
99348
Home/res vst est low mdm 30
$68$121-43%30
93296
Rem interrog evl pm/ids
$23$38-40%81
99497
Advncd care plan 30 min
$74$122-40%50

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 Colorado?

Aetna ranks 4th of 4 in Colorado with an index of 82. It is highest on 1% of codes.

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

About 5% above.

Which procedure does Aetna pay most above market in Colorado?

CPT 93298 (Rem interrog dev eval scrms), at 142% of the Colorado 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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