Aetna negotiated rates in Idaho
How Aetna's Idaho rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Idaho at a glance
What the data shows
Aetna ranks 1st of 4 payers in Idaho with a rate index of 112 (100 = the Idaho market median), across 227 procedure codes.
Aetna has the highest median for only 38% of codes in Idaho; Aetna leads with an index of 112 in the files analyzed.
Aetna's Idaho rates sit 52% above its own national level, the 2nd highest of its 51 states.
Largest premium over the Idaho market: CPT 88312 (Special stains group 1) at 232% of market; largest discount: CPT 99457 (Rpm tx mgmt 1st 20 min) at 69%.
How the four payers compare in Idaho
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Aetna | 112 | 1 | 38% | 491 | |
| Blue Cross Blue Shield | 107 | 2 | 25% | 547 | |
| UnitedHealthcare | 98 | 3 | 27% | 546 | |
| Cigna | 97 | 4 | 10% | 529 |
Where Aetna pays most and least against the Idaho market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 88312 Special stains group 1 | $200 | $86 | +132% | 59 |
| 88313 Special stains group 2 | $142 | $61 | +131% | 30 |
| 88342 Imhchem/imcytchm 1st antb | $180 | $81 | +122% | 33 |
| 88305 Tissue exam by pathologist | $129 | $64 | +103% | 64 |
| 36465 Njx noncmpnd sclrsnt 1 vein | $356 | $185 | +92% | 31 |
| 37243 Vasc embolize/occlude organ | $1,721 | $897 | +92% | 83 |
| 36482 Endoven ther chem adhes 1st | $536 | $310 | +73% | 25 |
| 33208 Insrt heart pm atrial & vent | $1,551 | $908 | +71% | 46 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 99457 Rpm tx mgmt 1st 20 min | $39 | $57 | -31% | 55 |
| 75574 Ct angio hrt w/3d image | $441 | $581 | -24% | 43 |
| 99454 Rem mntr physiol param 16-30 | $65 | $85 | -24% | 55 |
| 99497 Advncd care plan 30 min | $97 | $125 | -22% | 57 |
| 91110 Gi trc img intral esoph-ile | $1,038 | $1,302 | -20% | 38 |
| 99350 Home/res vst est high mdm 60 | $220 | $275 | -20% | 28 |
| 99348 Home/res vst est low mdm 30 | $103 | $128 | -19% | 28 |
| 99349 Home/res vst est mod mdm 40 | $158 | $195 | -19% | 46 |
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 Idaho?
Aetna ranks 1st of 4 in Idaho with an index of 112. It is highest on 38% of codes.
Are Aetna's Idaho rates above or below its national level?
About 52% above.
Which procedure does Aetna pay most above market in Idaho?
CPT 88312 (Special stains group 1), at 232% of the Idaho 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 Idaho?
Compare your negotiated rates for these codes with Idaho medians for each payer.