Aetna negotiated rates in Hawaii
How Aetna's Hawaii rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Hawaii at a glance
What the data shows
Aetna ranks 4th of 4 payers in Hawaii with a rate index of 97 (100 = the Hawaii market median), across 53 procedure codes.
Aetna has the highest median for only 23% of codes in Hawaii; Blue Cross Blue Shield leads with an index of 109 in the files analyzed.
Aetna's Hawaii rates sit 11% above its own national level, the 11th highest of its 51 states.
Largest premium over the Hawaii market: CPT 72141 (Mri neck spine w/o dye) at 170% of market; largest discount: CPT 99490 (Chrnc care mgmt staff 1st 20) at 53%.
How the four payers compare in Hawaii
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Blue Cross Blue Shield | 109 | 1 | 52% | 472 | |
| UnitedHealthcare | 100 | 2 | 64% | 453 | |
| Cigna | 100 | 2 | 63% | 413 | |
| Aetna | 97 | 4 | 23% | 114 |
Where Aetna pays most and least against the Hawaii market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 72141 Mri neck spine w/o dye | $475 | $279 | +70% | 40 |
| 72148 Mri lumbar spine w/o dye | $475 | $280 | +70% | 50 |
| 70551 Mri brain stem w/o dye | $475 | $288 | +65% | 40 |
| 73721 Mri jnt of lwr extre w/o dye | $475 | $302 | +58% | 50 |
| 73221 Mri joint upr extrem w/o dye | $475 | $304 | +56% | 50 |
| 72131 Ct lumbar spine w/o dye | $264 | $190 | +39% | 35 |
| 72125 Ct neck spine w/o dye | $266 | $191 | +39% | 35 |
| 77080 Dxa bone density axial | $80 | $57 | +39% | 35 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 99490 Chrnc care mgmt staff 1st 20 | $42 | $79 | -47% | 27 |
| 99212 Office o/p est sf 10 min | $43 | $74 | -42% | 107 |
| 99213 Office o/p est low 20 min | $71 | $118 | -40% | 106 |
| 99214 Office o/p est mod 30 min | $103 | $165 | -37% | 107 |
| 99215 Office o/p est hi 40 min | $145 | $230 | -37% | 105 |
| 45385 Colonoscopy w/lesion removal | $390 | $584 | -33% | 21 |
| 99203 Office o/p new low 30 min | $99 | $143 | -31% | 107 |
| 99205 Office o/p new hi 60 min | $195 | $281 | -30% | 97 |
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 Hawaii?
Aetna ranks 4th of 4 in Hawaii with an index of 97. It is highest on 23% of codes.
Are Aetna's Hawaii rates above or below its national level?
About 11% above.
Which procedure does Aetna pay most above market in Hawaii?
CPT 72141 (Mri neck spine w/o dye), at 170% of the Hawaii 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 Hawaii?
Compare your negotiated rates for these codes with Hawaii medians for each payer.