Aetna · Delaware · commercial in-network

Aetna negotiated rates in Delaware

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

Aetna in Delaware at a glance

Across 219 procedure codes for 8 specialties
Rate index vs state market
87
13% below the Delaware median
Rank in state
4 of 4
UHC 108 · Cigna 100 · BCBS 87 · Aetna 87
vs own national
91
Aetna's level vs its national median
Codes where highest
12%
of 219 codes
349 sampled providers271 TINs219 codesMedian 113% of Medicare · method

What the data shows

Generated from Delaware and Aetna data only
1

Aetna ranks 4th of 4 payers in Delaware with a rate index of 87 (100 = the Delaware market median), across 219 procedure codes.

2

Aetna has the highest median for only 12% of codes in Delaware; UnitedHealthcare leads with an index of 108 in the files analyzed.

3

Aetna's Delaware rates sit 9% below its own national level, the 38th highest of its 51 states.

4

Largest premium over the Delaware market: CPT 73564 (X-ray exam knee 4 or more) at 138% of market; largest discount: CPT 51702 (Insert temp bladder cath) at 46%.

How the four payers compare in Delaware

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1081
108
70%379
Cigna1002
100
16%392
Blue Cross Blue Shield873
87
10%170
Aetna874
87
12%349

Where Aetna pays most and least against the Delaware market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
73564
X-ray exam knee 4 or more
$77$56+38%53
73562
X-ray exam of knee 3
$66$49+36%53
73030
X-ray exam of shoulder
$56$41+36%53
73610
X-ray exam of ankle
$58$43+35%53
73560
X-ray exam of knee 1 or 2
$54$41+32%53
73630
X-ray exam of foot
$53$41+29%53
72100
X-ray exam l-s spine 2/3 vws
$63$52+22%53
43259
Egd us exam duodenum/jejunum
$410$339+21%19

Furthest below market

CodeAetnaMarketGapProv.
51702
Insert temp bladder cath
$27$60-54%24
52000
Cystourethroscopy
$86$182-53%28
99457
Rpm tx mgmt 1st 20 min
$27$49-46%84
51720
Treatment of bladder lesion
$46$85-45%22
77080
Dxa bone density axial
$37$67-44%54
71275
Ct angiography chest
$299$534-44%54
70496
Ct angiography head
$295$523-44%54
70498
Ct angiography neck
$295$522-44%54

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 Delaware?

Aetna ranks 4th of 4 in Delaware with an index of 87. It is highest on 12% of codes.

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

About 9% below.

Which procedure does Aetna pay most above market in Delaware?

CPT 73564 (X-ray exam knee 4 or more), at 138% of the Delaware 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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