Aetna · Iowa · commercial in-network

Aetna negotiated rates in Iowa

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

Aetna overviewIowa marketSnapshot Aug 2026

Aetna in Iowa at a glance

Across 202 procedure codes for 8 specialties
Rate index vs state market
64
36% below the Iowa median
Rank in state
4 of 4
UHC 118 · Cigna 117 · BCBS 99 · Aetna 64
vs own national
98
Aetna's level vs its national median
Codes where highest
0%
of 202 codes
295 sampled providers196 TINs202 codesMedian 118% of Medicare · method

What the data shows

Generated from Iowa and Aetna data only
1

Aetna ranks 4th of 4 payers in Iowa with a rate index of 64 (100 = the Iowa market median), across 202 procedure codes.

2

Aetna has the highest median for only 0% of codes in Iowa; UnitedHealthcare leads with an index of 118 in the files analyzed.

3

Aetna's Iowa rates sit 2% below its own national level, the 28th highest of its 51 states.

4

Largest premium over the Iowa market: CPT 15260 (Fth/gft fr n/e/e/l 20 sqcm/<) at 122% of market; largest discount: CPT 92250 (Fundus photography w/i&r) at 43%.

How the four payers compare in Iowa

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1181
118
47%605
Cigna1172
117
46%604
Blue Cross Blue Shield993
99
8%687
Aetna644
64
0%295

Where Aetna pays most and least against the Iowa market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
15260
Fth/gft fr n/e/e/l 20 sqcm/<
$1,762$1,445+22%17
14041
Tis trnfr f/c/c/m/n/a/g/h/f
$1,587$1,317+20%17
14061
Tis trnfr e/n/e/l10.1-30sqcm
$1,534$1,417+8%17
65778
Cover eye w/membrane
$78$78+0%22
12052
Intmd rpr face/mm 2.6-5.0 cm
$415$415+0%19
37243
Vasc embolize/occlude organ
$908$1,006-10%25
14060
Tis trnfr e/n/e/l 10 sq cm/<
$1,026$1,139-10%18
17000
Destruct premalg lesion
$85$95-10%23

Furthest below market

CodeAetnaMarketGapProv.
92250
Fundus photography w/i&r
$38$89-57%23
92136
Ophthalmic biometry
$51$119-57%24
92235
Fluorescein angrph mltiframe
$127$283-55%23
88342
Imhchem/imcytchm 1st antb
$107$230-54%19
73221
Mri joint upr extrem w/o dye
$222$478-54%54
73721
Mri jnt of lwr extre w/o dye
$221$477-54%54
76857
Us exam pelvic limited
$44$94-53%17
76856
Us exam pelvic complete
$92$193-52%19

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 Iowa?

Aetna ranks 4th of 4 in Iowa with an index of 64. It is highest on 0% of codes.

Are Aetna&#39;s Iowa rates above or below its national level?

About 2% below.

Which procedure does Aetna pay most above market in Iowa?

CPT 15260 (Fth/gft fr n/e/e/l 20 sqcm/<), at 122% of the Iowa 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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