Aetna · Michigan · commercial in-network

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

Across 228 procedure codes for 8 specialties
Rate index vs state market
92
8% below the Michigan median
Rank in state
4 of 4
Cigna 123 · UHC 106 · BCBS 100 · Aetna 92
vs own national
100
Aetna's level vs its national median
Codes where highest
1%
of 228 codes
707 sampled providers608 TINs228 codesMedian 123% of Medicare · method

What the data shows

Generated from Michigan and Aetna data only
1

Aetna ranks 4th of 4 payers in Michigan with a rate index of 92 (100 = the Michigan market median), across 228 procedure codes.

2

Aetna has the highest median for only 1% of codes in Michigan; Cigna leads with an index of 123 in the files analyzed.

3

Aetna's Michigan rates sit 0% above its own national level, the 23rd highest of its 51 states.

4

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

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
Cigna1231
123
87%93
UnitedHealthcare1062
106
44%664
Blue Cross Blue Shield1003
100
34%846
Aetna924
92
1%707

Where Aetna pays most and least against the Michigan market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
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

CodeAetnaMarketGapProv.
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

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 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

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.

Is your Aetna contract at market in Michigan?

Compare your negotiated rates for these codes with Michigan medians for each payer.

Request a rate benchmark