Aetna negotiated rates in Maine
How Aetna's Maine rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Maine at a glance
What the data shows
Aetna ranks 4th of 4 payers in Maine with a rate index of 85 (100 = the Maine market median), across 223 procedure codes.
Aetna has the highest median for only 4% of codes in Maine; UnitedHealthcare leads with an index of 124 in the files analyzed.
Aetna's Maine rates sit 3% above its own national level, the 19th highest of its 51 states.
Largest premium over the Maine market: CPT 37243 (Vasc embolize/occlude organ) at 129% of market; largest discount: CPT 99487 (Cplx chrnc care 1st 60 min) at 32%.
How the four payers compare in Maine
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 124 | 1 | 74% | 546 | |
| Blue Cross Blue Shield | 103 | 2 | 18% | 215 | |
| Cigna | 100 | 3 | 9% | 597 | |
| Aetna | 85 | 4 | 4% | 552 |
Where Aetna pays most and least against the Maine market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 37243 Vasc embolize/occlude organ | $1,119 | $869 | +29% | 95 |
| 72131 Ct lumbar spine w/o dye | $260 | $220 | +18% | 104 |
| 72125 Ct neck spine w/o dye | $262 | $228 | +14% | 107 |
| 71260 Ct thorax dx c+ | $321 | $290 | +11% | 105 |
| 74174 Cta abd&plvs w/contrast | $615 | $560 | +10% | 103 |
| 70450 Ct head/brain w/o dye | $186 | $170 | +9% | 108 |
| 71250 Ct thorax dx c- | $245 | $225 | +9% | 107 |
| 51798 Us urine capacity measure | $25 | $23 | +9% | 38 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 99487 Cplx chrnc care 1st 60 min | $46 | $145 | -68% | 23 |
| 93297 Rem interrog dev eval icpms | $30 | $92 | -67% | 26 |
| 96372 Ther/proph/diag inj sc/im | $15 | $28 | -46% | 102 |
| 14041 Tis trnfr f/c/c/m/n/a/g/h/f | $741 | $1,335 | -44% | 21 |
| 99490 Chrnc care mgmt staff 1st 20 | $36 | $64 | -43% | 214 |
| 14061 Tis trnfr e/n/e/l10.1-30sqcm | $797 | $1,398 | -43% | 25 |
| 17000 Destruct premalg lesion | $52 | $91 | -43% | 29 |
| 15260 Fth/gft fr n/e/e/l 20 sqcm/< | $801 | $1,398 | -43% | 27 |
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 Maine?
Aetna ranks 4th of 4 in Maine with an index of 85. It is highest on 4% of codes.
Are Aetna's Maine rates above or below its national level?
About 3% above.
Which procedure does Aetna pay most above market in Maine?
CPT 37243 (Vasc embolize/occlude organ), at 129% of the Maine 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 Maine?
Compare your negotiated rates for these codes with Maine medians for each payer.