Aetna · Hawaii · commercial in-network

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

Across 53 procedure codes for 8 specialties
Rate index vs state market
97
3% below the Hawaii median
Rank in state
4 of 4
BCBS 109 · UHC 100 · Cigna 100 · Aetna 97
vs own national
111
Aetna's level vs its national median
Codes where highest
23%
of 53 codes
114 sampled providers240 TINs53 codesMedian 143% of Medicare · method

What the data shows

Generated from Hawaii and Aetna data only
1

Aetna ranks 4th of 4 payers in Hawaii with a rate index of 97 (100 = the Hawaii market median), across 53 procedure codes.

2

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.

3

Aetna's Hawaii rates sit 11% above its own national level, the 11th highest of its 51 states.

4

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

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
Blue Cross Blue Shield1091
109
52%472
UnitedHealthcare1002
100
64%453
Cigna1002
100
63%413
Aetna974
97
23%114

Where Aetna pays most and least against the Hawaii market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
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

CodeAetnaMarketGapProv.
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

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 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

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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