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
What the data shows
Aetna ranks 4th of 4 payers in Florida with a rate index of 85 (100 = the Florida market median), across 228 procedure codes.
Aetna has the highest median for only 4% of codes in Florida; UnitedHealthcare leads with an index of 112 in the files analyzed.
Aetna's Florida rates sit 18% below its own national level, the 49th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 112 | 1 | 59% | 744 | |
| Blue Cross Blue Shield | 107 | 2 | 34% | 200 | |
| Cigna | 96 | 3 | 13% | 775 | |
| Aetna | 85 | 4 | 4% | 758 |
Where Aetna pays most and least against the Florida market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 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
- 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 Florida?
Compare your negotiated rates for these codes with Florida medians for each payer.