Aetna · Oregon · commercial in-network

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

Across 225 procedure codes for 8 specialties
Rate index vs state market
71
29% below the Oregon median
Rank in state
4 of 4
UHC 121 · Cigna 100 · BCBS 90 · Aetna 71
vs own national
126
Aetna's level vs its national median
Codes where highest
5%
of 225 codes
494 sampled providers467 TINs225 codesMedian 159% of Medicare · method

What the data shows

Generated from Oregon and Aetna data only
1

Aetna ranks 4th of 4 payers in Oregon with a rate index of 71 (100 = the Oregon market median), across 225 procedure codes.

2

Aetna has the highest median for only 5% of codes in Oregon; UnitedHealthcare leads with an index of 121 in the files analyzed.

3

Aetna's Oregon rates sit 26% above its own national level, the 8th highest of its 51 states.

4

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

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1211
121
78%683
Cigna1002
100
10%735
Blue Cross Blue Shield903
90
7%351
Aetna714
71
5%494

Where Aetna pays most and least against the Oregon market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
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

CodeAetnaMarketGapProv.
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

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 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

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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