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 in Iowa at a glance
What the data shows
Aetna ranks 4th of 4 payers in Iowa with a rate index of 64 (100 = the Iowa market median), across 202 procedure codes.
Aetna has the highest median for only 0% of codes in Iowa; UnitedHealthcare leads with an index of 118 in the files analyzed.
Aetna's Iowa rates sit 2% below its own national level, the 28th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 118 | 1 | 47% | 605 | |
| Cigna | 117 | 2 | 46% | 604 | |
| Blue Cross Blue Shield | 99 | 3 | 8% | 687 | |
| Aetna | 64 | 4 | 0% | 295 |
Where Aetna pays most and least against the Iowa market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 Iowa?
Aetna ranks 4th of 4 in Iowa with an index of 64. It is highest on 0% of codes.
Are Aetna'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
- 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 Iowa?
Compare your negotiated rates for these codes with Iowa medians for each payer.