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
What the data shows
Aetna ranks 4th of 4 payers in Missouri with a rate index of 82 (100 = the Missouri market median), across 228 procedure codes.
Aetna has the highest median for only 6% of codes in Missouri; UnitedHealthcare leads with an index of 112 in the files analyzed.
Aetna's Missouri rates sit 8% below its own national level, the 37th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 112 | 1 | 67% | 821 | |
| Blue Cross Blue Shield | 100 | 2 | 20% | 902 | |
| Cigna | 96 | 3 | 7% | 849 | |
| Aetna | 82 | 4 | 6% | 630 |
Where Aetna pays most and least against the Missouri market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 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
- 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 Missouri?
Compare your negotiated rates for these codes with Missouri medians for each payer.