Aetna · Kentucky · commercial in-network

Aetna negotiated rates in Kentucky

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

Aetna in Kentucky at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
82
18% below the Kentucky median
Rank in state
4 of 4
UHC 114 · Cigna 111 · BCBS 89 · Aetna 82
vs own national
89
Aetna's level vs its national median
Codes where highest
2%
of 228 codes
681 sampled providers478 TINs228 codesMedian 113% of Medicare · method

What the data shows

Generated from Kentucky and Aetna data only
1

Aetna ranks 4th of 4 payers in Kentucky with a rate index of 82 (100 = the Kentucky market median), across 228 procedure codes.

2

Aetna has the highest median for only 2% of codes in Kentucky; UnitedHealthcare leads with an index of 114 in the files analyzed.

3

Aetna's Kentucky rates sit 11% below its own national level, the 42nd highest of its 51 states.

4

Largest premium over the Kentucky market: CPT 93298 (Rem interrog dev eval scrms) at 233% of market; largest discount: CPT 51720 (Treatment of bladder lesion) at 47%.

How the four payers compare in Kentucky

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1141
114
53%820
Cigna1112
111
43%848
Blue Cross Blue Shield893
89
3%935
Aetna824
82
2%681

Where Aetna pays most and least against the Kentucky market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
93298
Rem interrog dev eval scrms
$113$49+133%79
88313
Special stains group 2
$94$61+54%39
93297
Rem interrog dev eval icpms
$69$48+42%68
43274
Ercp duct stent placement
$801$689+16%69
92242
Fluorescein&icg angiography
$290$252+15%68
71271
Ct thorax lung cancer scr c-
$170$158+7%87
73502
X-ray exam hip uni 2-3 views
$52$49+6%163
88312
Special stains group 1
$87$83+6%129

Furthest below market

CodeAetnaMarketGapProv.
51720
Treatment of bladder lesion
$55$118-53%44
64566
Neuroeltrd stim post tibial
$29$57-49%22
51700
Irrigation of bladder
$40$79-49%62
52648
Laser surgery of prostate
$783$1,443-46%29
99454
Rem mntr physiol param 16-30
$35$65-45%90
52224
Cystoscopy and treatment
$255$447-43%44
99457
Rpm tx mgmt 1st 20 min
$26$45-43%90
55866
Laps surg prst8ect rpbic rad
$1,278$2,182-41%45

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 Kentucky?

Aetna ranks 4th of 4 in Kentucky with an index of 82. It is highest on 2% of codes.

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

About 11% below.

Which procedure does Aetna pay most above market in Kentucky?

CPT 93298 (Rem interrog dev eval scrms), at 233% of the Kentucky 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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