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
What the data shows
Aetna ranks 4th of 4 payers in Colorado with a rate index of 82 (100 = the Colorado market median), across 227 procedure codes.
Aetna has the highest median for only 1% of codes in Colorado; UnitedHealthcare leads with an index of 113 in the files analyzed.
Aetna's Colorado rates sit 5% above its own national level, the 17th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 113 | 1 | 74% | 749 | |
| Blue Cross Blue Shield | 100 | 2 | 22% | 796 | |
| Cigna | 94 | 3 | 3% | 752 | |
| Aetna | 82 | 4 | 1% | 717 |
Where Aetna pays most and least against the Colorado market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 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
- 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 Colorado?
Compare your negotiated rates for these codes with Colorado medians for each payer.