Aetna · Missouri · commercial in-network

Aetna negotiated rates in Missouri

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

Aetna in Missouri at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
82
18% below the Missouri median
Rank in state
4 of 4
UHC 112 · BCBS 100 · Cigna 96 · Aetna 82
vs own national
92
Aetna's level vs its national median
Codes where highest
6%
of 228 codes
630 sampled providers463 TINs228 codesMedian 123% of Medicare · method

What the data shows

Generated from Missouri and Aetna data only
1

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

2

Aetna has the highest median for only 6% of codes in Missouri; UnitedHealthcare leads with an index of 112 in the files analyzed.

3

Aetna's Missouri rates sit 8% below its own national level, the 37th highest of its 51 states.

4

Largest premium over the Missouri market: CPT 93298 (Rem interrog dev eval scrms) at 204% of market; largest discount: CPT 51702 (Insert temp bladder cath) at 51%.

How the four payers compare in Missouri

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1121
112
67%821
Blue Cross Blue Shield1002
100
20%902
Cigna963
96
7%849
Aetna824
82
6%630

Where Aetna pays most and least against the Missouri market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
93298
Rem interrog dev eval scrms
$104$51+104%66
88313
Special stains group 2
$96$71+35%49
74183
Mri abd w/o cntr flwd cntr
$719$624+15%83
72197
Mri pelvis w/o & w/dye
$717$624+15%81
90960
Esrd srv 4 visits p mo 20+
$478$420+14%33
93280
Pm device progr eval dual
$127$113+12%66
88312
Special stains group 1
$105$94+12%134
70551
Mri brain stem w/o dye
$419$379+11%84

Furthest below market

CodeAetnaMarketGapProv.
51702
Insert temp bladder cath
$33$65-49%79
11302
Shave skin lesion 1.1-2.0 cm
$55$106-48%71
45384
Colonoscopy w/lesion removal
$255$486-48%52
11301
Shave skin lesion 0.6-1.0 cm
$47$87-45%82
99348
Home/res vst est low mdm 30
$55$100-45%24
99349
Home/res vst est mod mdm 40
$86$153-44%39
11104
Punch bx skin single lesion
$44$75-42%82
11102
Tangntl bx skin single les
$35$60-42%83

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 Missouri?

Aetna ranks 4th of 4 in Missouri with an index of 82. It is highest on 6% of codes.

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

About 8% below.

Which procedure does Aetna pay most above market in Missouri?

CPT 93298 (Rem interrog dev eval scrms), at 204% of the Missouri 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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