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
What the data shows
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.
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.
Aetna's North Dakota rates sit 15% below its own national level, the 47th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| Blue Cross Blue Shield | 111 | 1 | 68% | 329 | |
| UnitedHealthcare | 102 | 2 | 28% | 210 | |
| Cigna | 81 | 3 | 14% | 71 | |
| Aetna | 54 | 4 | 0% | 211 |
Where Aetna pays most and least against the North Dakota market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 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
- 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.