Aetna negotiated rates in Rhode Island
How Aetna's Rhode Island rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Rhode Island at a glance
What the data shows
Aetna ranks 4th of 4 payers in Rhode Island with a rate index of 87 (100 = the Rhode Island market median), across 227 procedure codes.
Aetna has the highest median for only 12% of codes in Rhode Island; UnitedHealthcare leads with an index of 129 in the files analyzed.
Aetna's Rhode Island rates sit 3% above its own national level, the 18th highest of its 51 states.
Largest premium over the Rhode Island market: CPT 92250 (Fundus photography w/i&r) at 198% of market; largest discount: CPT 64566 (Neuroeltrd stim post tibial) at 54%.
How the four payers compare in Rhode Island
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 129 | 1 | 60% | 468 | |
| Cigna | 110 | 2 | 26% | 562 | |
| Blue Cross Blue Shield | 90 | 3 | 1% | 581 | |
| Aetna | 87 | 4 | 12% | 422 |
Where Aetna pays most and least against the Rhode Island market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 92250 Fundus photography w/i&r | $93 | $47 | +98% | 47 |
| 77080 Dxa bone density axial | $98 | $56 | +76% | 54 |
| 92136 Ophthalmic biometry | $105 | $62 | +71% | 46 |
| 92083 Extended visual field xm | $107 | $69 | +54% | 47 |
| 72148 Mri lumbar spine w/o dye | $600 | $402 | +49% | 94 |
| 72141 Mri neck spine w/o dye | $600 | $404 | +48% | 55 |
| 92133 Cptrzd oph dx img pst sgm on | $56 | $38 | +46% | 47 |
| 70551 Mri brain stem w/o dye | $600 | $416 | +44% | 55 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 64566 Neuroeltrd stim post tibial | $36 | $66 | -46% | 19 |
| 99490 Chrnc care mgmt staff 1st 20 | $33 | $58 | -42% | 132 |
| 11301 Shave skin lesion 0.6-1.0 cm | $54 | $92 | -42% | 23 |
| 52224 Cystoscopy and treatment | $233 | $397 | -41% | 38 |
| 99457 Rpm tx mgmt 1st 20 min | $33 | $55 | -40% | 65 |
| 71045 X-ray exam chest 1 view | $20 | $33 | -39% | 54 |
| 93297 Rem interrog dev eval icpms | $32 | $52 | -38% | 44 |
| 26055 Incise finger tendon sheath | $394 | $639 | -38% | 85 |
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 Rhode Island?
Aetna ranks 4th of 4 in Rhode Island with an index of 87. It is highest on 12% of codes.
Are Aetna's Rhode Island rates above or below its national level?
About 3% above.
Which procedure does Aetna pay most above market in Rhode Island?
CPT 92250 (Fundus photography w/i&r), at 198% of the Rhode Island 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 Rhode Island?
Compare your negotiated rates for these codes with Rhode Island medians for each payer.