Aetna · Florida · commercial in-network

Aetna negotiated rates in Florida

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

Aetna in Florida at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
85
15% below the Florida median
Rank in state
4 of 4
UHC 112 · BCBS 107 · Cigna 96 · Aetna 85
vs own national
82
Aetna's level vs its national median
Codes where highest
4%
of 228 codes
758 sampled providers723 TINs228 codesMedian 97% of Medicare · method

What the data shows

Generated from Florida and Aetna data only
1

Aetna ranks 4th of 4 payers in Florida with a rate index of 85 (100 = the Florida market median), across 228 procedure codes.

2

Aetna has the highest median for only 4% of codes in Florida; UnitedHealthcare leads with an index of 112 in the files analyzed.

3

Aetna's Florida rates sit 18% below its own national level, the 49th highest of its 51 states.

4

Largest premium over the Florida market: CPT 88305 (Tissue exam by pathologist) at 128% of market; largest discount: CPT 99426 (Prin care mgmt staff 1st 30) at 61%.

How the four payers compare in Florida

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1121
112
59%744
Blue Cross Blue Shield1072
107
34%200
Cigna963
96
13%775
Aetna854
85
4%758

Where Aetna pays most and least against the Florida market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
88305
Tissue exam by pathologist
$63$49+28%171
88313
Special stains group 2
$54$44+22%73
72148
Mri lumbar spine w/o dye
$338$289+17%128
73221
Mri joint upr extrem w/o dye
$350$305+15%129
73721
Mri jnt of lwr extre w/o dye
$347$305+14%130
88312
Special stains group 1
$67$62+9%159
70450
Ct head/brain w/o dye
$184$174+6%66
99202
Office o/p new sf 15 min
$62$59+5%102

Furthest below market

CodeAetnaMarketGapProv.
99426
Prin care mgmt staff 1st 30
$45$74-39%56
51729
Cystometrogram w/vp&up
$303$482-37%85
51728
Cystometrogram w/vp
$280$443-37%95
74178
Ct abd&plv wo cntr flwd cntr
$250$395-37%143
75574
Ct angio hrt w/3d image
$188$297-37%79
99457
Rpm tx mgmt 1st 20 min
$28$43-35%114
67840
Remove eyelid lesion
$127$191-34%79
96910
Photchmtx tar&uvb/ptrltm&uvb
$56$84-33%84

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 Florida?

Aetna ranks 4th of 4 in Florida with an index of 85. It is highest on 4% of codes.

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

About 18% below.

Which procedure does Aetna pay most above market in Florida?

CPT 88305 (Tissue exam by pathologist), at 128% of the Florida 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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