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
What the data shows
Aetna ranks 4th of 4 payers in Delaware with a rate index of 87 (100 = the Delaware market median), across 219 procedure codes.
Aetna has the highest median for only 12% of codes in Delaware; UnitedHealthcare leads with an index of 108 in the files analyzed.
Aetna's Delaware rates sit 9% below its own national level, the 38th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 108 | 1 | 70% | 379 | |
| Cigna | 100 | 2 | 16% | 392 | |
| Blue Cross Blue Shield | 87 | 3 | 10% | 170 | |
| Aetna | 87 | 4 | 12% | 349 |
Where Aetna pays most and least against the Delaware market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 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
- 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 Delaware?
Compare your negotiated rates for these codes with Delaware medians for each payer.