Aetna · Indiana · commercial in-network

Aetna negotiated rates in Indiana

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

Aetna in Indiana at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
78
22% below the Indiana median
Rank in state
4 of 4
UHC 117 · Cigna 103 · BCBS 100 · Aetna 78
vs own national
80
Aetna's level vs its national median
Codes where highest
1%
of 228 codes
698 sampled providers514 TINs228 codesMedian 103% of Medicare · method

What the data shows

Generated from Indiana and Aetna data only
1

Aetna ranks 4th of 4 payers in Indiana with a rate index of 78 (100 = the Indiana market median), across 228 procedure codes.

2

Aetna has the highest median for only 1% of codes in Indiana; UnitedHealthcare leads with an index of 117 in the files analyzed.

3

Aetna's Indiana rates sit 20% below its own national level, the 51st highest of its 51 states.

4

Largest premium over the Indiana market: CPT 88313 (Special stains group 2) at 134% of market; largest discount: CPT 72141 (Mri neck spine w/o dye) at 46%.

How the four payers compare in Indiana

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1171
117
61%805
Cigna1032
103
17%812
Blue Cross Blue Shield1003
100
21%912
Aetna784
78
1%698

Where Aetna pays most and least against the Indiana market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
88313
Special stains group 2
$62$46+34%41
88312
Special stains group 1
$86$64+34%116
88342
Imhchem/imcytchm 1st antb
$85$64+33%76
96910
Photchmtx tar&uvb/ptrltm&uvb
$108$91+18%53
77280
Ther rad simulaj field smpl
$278$239+16%52
68761
Close tear duct opening
$137$131+5%80
73630
X-ray exam of foot
$37$35+5%85
72100
X-ray exam l-s spine 2/3 vws
$43$41+3%85

Furthest below market

CodeAetnaMarketGapProv.
72141
Mri neck spine w/o dye
$196$428-54%105
70551
Mri brain stem w/o dye
$201$420-52%106
72148
Mri lumbar spine w/o dye
$196$404-52%180
45384
Colonoscopy w/lesion removal
$233$475-51%47
77080
Dxa bone density axial
$34$68-50%104
73721
Mri jnt of lwr extre w/o dye
$207$412-50%178
73221
Mri joint upr extrem w/o dye
$208$412-50%179
43239
Egd biopsy single/multiple
$180$356-49%70

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 Indiana?

Aetna ranks 4th of 4 in Indiana with an index of 78. It is highest on 1% of codes.

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

About 20% below.

Which procedure does Aetna pay most above market in Indiana?

CPT 88313 (Special stains group 2), at 134% of the Indiana 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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