Aetna · North Dakota · commercial in-network

Aetna negotiated rates in North Dakota

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

Aetna in North Dakota at a glance

Across 139 procedure codes for 8 specialties
Rate index vs state market
54
46% below the North Dakota median
Rank in state
4 of 4
BCBS 111 · UHC 102 · Cigna 81 · Aetna 54
vs own national
85
Aetna's level vs its national median
Codes where highest
0%
of 139 codes
211 sampled providers210 TINs139 codesMedian 108% of Medicare · method

What the data shows

Generated from North Dakota and Aetna data only
1

Aetna ranks 4th of 4 payers in North Dakota with a rate index of 54 (100 = the North Dakota market median), across 139 procedure codes.

2

Aetna has the highest median for only 0% of codes in North Dakota; Blue Cross Blue Shield leads with an index of 111 in the files analyzed.

3

Aetna's North Dakota rates sit 15% below its own national level, the 47th highest of its 51 states.

4

Largest premium over the North Dakota market: CPT 70551 (Mri brain stem w/o dye) at 67% of market; largest discount: CPT 93298 (Rem interrog dev eval scrms) at 26%.

How the four payers compare in North Dakota

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
Blue Cross Blue Shield1111
111
68%329
UnitedHealthcare1022
102
28%210
Cigna813
81
14%71
Aetna544
54
0%211

Where Aetna pays most and least against the North Dakota market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
70551
Mri brain stem w/o dye
$267$396-33%50
92136
Ophthalmic biometry
$63$95-34%18
70553
Mri brain stem w/o & w/dye
$425$642-34%50
72158
Mri lumbar spine w/o & w/dye
$425$645-34%49
65778
Cover eye w/membrane
$55$84-34%18
72131
Ct lumbar spine w/o dye
$172$263-35%50
72141
Mri neck spine w/o dye
$253$392-35%53
99202
Office o/p new sf 15 min
$57$88-35%15

Furthest below market

CodeAetnaMarketGapProv.
93298
Rem interrog dev eval scrms
$28$105-74%16
99487
Cplx chrnc care 1st 60 min
$69$204-66%32
93297
Rem interrog dev eval icpms
$27$72-62%16
88312
Special stains group 1
$75$196-62%27
20611
Drain/inj joint/bursa w/us
$60$152-60%17
99350
Home/res vst est high mdm 60
$152$372-59%34
88305
Tissue exam by pathologist
$50$120-59%28
99495
Transj care mgmt mod f2f 14d
$134$314-57%49

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 North Dakota?

Aetna ranks 4th of 4 in North Dakota with an index of 54. It is highest on 0% of codes.

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

About 15% below.

Which procedure does Aetna pay most above market in North Dakota?

CPT 70551 (Mri brain stem w/o dye), at 67% of the North Dakota 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 North Dakota?

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

Request a rate benchmark