Aetna negotiated rates in Oregon
How Aetna's Oregon rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Oregon at a glance
What the data shows
Aetna ranks 4th of 4 payers in Oregon with a rate index of 71 (100 = the Oregon market median), across 225 procedure codes.
Aetna has the highest median for only 5% of codes in Oregon; UnitedHealthcare leads with an index of 121 in the files analyzed.
Aetna's Oregon rates sit 26% above its own national level, the 8th highest of its 51 states.
Largest premium over the Oregon market: CPT 70450 (Ct head/brain w/o dye) at 174% of market; largest discount: CPT 93298 (Rem interrog dev eval scrms) at 24%.
How the four payers compare in Oregon
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 121 | 1 | 78% | 683 | |
| Cigna | 100 | 2 | 10% | 735 | |
| Blue Cross Blue Shield | 90 | 3 | 7% | 351 | |
| Aetna | 71 | 4 | 5% | 494 |
Where Aetna pays most and least against the Oregon market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 70450 Ct head/brain w/o dye | $371 | $214 | +74% | 69 |
| 72141 Mri neck spine w/o dye | $603 | $403 | +50% | 68 |
| 72148 Mri lumbar spine w/o dye | $603 | $413 | +46% | 115 |
| 70551 Mri brain stem w/o dye | $603 | $414 | +46% | 69 |
| 72131 Ct lumbar spine w/o dye | $371 | $266 | +39% | 70 |
| 73721 Mri jnt of lwr extre w/o dye | $603 | $435 | +39% | 121 |
| 72125 Ct neck spine w/o dye | $371 | $268 | +38% | 69 |
| 73221 Mri joint upr extrem w/o dye | $603 | $436 | +38% | 118 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 93298 Rem interrog dev eval scrms | $42 | $174 | -76% | 44 |
| 43235 Egd diagnostic brush wash | $209 | $772 | -73% | 38 |
| 45380 Colonoscopy and biopsy | $338 | $1,159 | -71% | 38 |
| 99487 Cplx chrnc care 1st 60 min | $71 | $231 | -69% | 17 |
| 45378 Diagnostic colonoscopy | $286 | $916 | -69% | 38 |
| 99490 Chrnc care mgmt staff 1st 20 | $40 | $121 | -67% | 118 |
| 93297 Rem interrog dev eval icpms | $34 | $102 | -67% | 28 |
| 43251 Egd remove lesion snare | $295 | $800 | -63% | 33 |
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 Oregon?
Aetna ranks 4th of 4 in Oregon with an index of 71. It is highest on 5% of codes.
Are Aetna's Oregon rates above or below its national level?
About 26% above.
Which procedure does Aetna pay most above market in Oregon?
CPT 70450 (Ct head/brain w/o dye), at 174% of the Oregon 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 Oregon?
Compare your negotiated rates for these codes with Oregon medians for each payer.