Aetna negotiated rates in Michigan
How Aetna's Michigan rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Michigan at a glance
What the data shows
Aetna ranks 4th of 4 payers in Michigan with a rate index of 92 (100 = the Michigan market median), across 228 procedure codes.
Aetna has the highest median for only 1% of codes in Michigan; Cigna leads with an index of 123 in the files analyzed.
Aetna's Michigan rates sit 0% above its own national level, the 23rd highest of its 51 states.
Largest premium over the Michigan market: CPT 93010 (Electrocardiogram report) at 105% of market; largest discount: CPT 99348 (Home/res vst est low mdm 30) at 62%.
How the four payers compare in Michigan
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Cigna | 123 | 1 | 87% | 93 | |
| UnitedHealthcare | 106 | 2 | 44% | 664 | |
| Blue Cross Blue Shield | 100 | 3 | 34% | 846 | |
| Aetna | 92 | 4 | 1% | 707 |
Where Aetna pays most and least against the Michigan market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 93010 Electrocardiogram report | $11 | $10 | +5% | 107 |
| 68761 Close tear duct opening | $164 | $156 | +5% | 92 |
| 65778 Cover eye w/membrane | $72 | $69 | +4% | 79 |
| 67210 Treatment of retinal lesion | $664 | $641 | +4% | 83 |
| 66991 Xcapsl ctrc rmvl insj 1+ | $911 | $879 | +4% | 63 |
| 12032 Intmd rpr s/a/t/ext 2.6-7.5 | $225 | $220 | +2% | 90 |
| 17000 Destruct premalg lesion | $65 | $63 | +2% | 91 |
| 88312 Special stains group 1 | $134 | $131 | +2% | 169 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 99348 Home/res vst est low mdm 30 | $66 | $107 | -38% | 52 |
| 99454 Rem mntr physiol param 16-30 | $48 | $75 | -36% | 122 |
| 26055 Incise finger tendon sheath | $406 | $623 | -35% | 76 |
| 99350 Home/res vst est high mdm 60 | $163 | $241 | -32% | 44 |
| 17311 Mohs 1 stage h/n/hf/g | $416 | $612 | -32% | 87 |
| 99349 Home/res vst est mod mdm 40 | $112 | $162 | -31% | 54 |
| 50590 Fragmenting of kidney stone | $724 | $1,035 | -30% | 78 |
| 99202 Office o/p new sf 15 min | $52 | $74 | -29% | 91 |
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 Michigan?
Aetna ranks 4th of 4 in Michigan with an index of 92. It is highest on 1% of codes.
Are Aetna's Michigan rates above or below its national level?
About 0% above.
Which procedure does Aetna pay most above market in Michigan?
CPT 93010 (Electrocardiogram report), at 105% of the Michigan 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 Michigan?
Compare your negotiated rates for these codes with Michigan medians for each payer.