Aetna · South Dakota · commercial in-network

Aetna negotiated rates in South Dakota

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

Aetna in South Dakota at a glance

Across 70 procedure codes for 8 specialties
Rate index vs state market
51
49% below the South Dakota median
Rank in state
4 of 4
UHC 104 · Cigna 103 · BCBS 100 · Aetna 51
vs own national
82
Aetna's level vs its national median
Codes where highest
0%
of 70 codes
147 sampled providers127 TINs70 codesMedian 96% of Medicare · method

What the data shows

Generated from South Dakota and Aetna data only
1

Aetna ranks 4th of 4 payers in South Dakota with a rate index of 51 (100 = the South Dakota market median), across 70 procedure codes.

2

Aetna has the highest median for only 0% of codes in South Dakota; UnitedHealthcare leads with an index of 104 in the files analyzed.

3

Aetna's South Dakota rates sit 18% below its own national level, the 50th highest of its 51 states.

4

Largest premium over the South Dakota market: CPT 27447 (Total knee arthroplasty) at 108% of market; largest discount: CPT 77049 (Mri breast c-+ w/cad bi) at 43%.

How the four payers compare in South Dakota

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1041
104
43%316
Cigna1032
103
41%286
Blue Cross Blue Shield1003
100
20%457
Aetna514
51
0%147

Where Aetna pays most and least against the South Dakota market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
27447
Total knee arthroplasty
$3,183$2,960+8%26
72100
X-ray exam l-s spine 2/3 vws
$75$78-4%27
27130
Total hip arthroplasty
$2,850$2,967-4%26
97110
Therapeutic exercises
$40$43-7%23
73721
Mri jnt of lwr extre w/o dye
$379$476-20%56
73562
X-ray exam of knee 3
$60$80-25%26
99495
Transj care mgmt mod f2f 14d
$155$211-27%18
99212
Office o/p est sf 10 min
$38$53-28%135

Furthest below market

CodeAetnaMarketGapProv.
77049
Mri breast c-+ w/cad bi
$317$742-57%28
72125
Ct neck spine w/o dye
$121$282-57%27
74183
Mri abd w/o cntr flwd cntr
$317$730-57%27
72158
Mri lumbar spine w/o & w/dye
$299$684-56%27
70551
Mri brain stem w/o dye
$183$415-56%27
99457
Rpm tx mgmt 1st 20 min
$28$61-55%18
76700
Us exam abdom complete
$105$229-54%27
77067
Scr mammo bi incl cad
$117$255-54%32

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 South Dakota?

Aetna ranks 4th of 4 in South Dakota with an index of 51. It is highest on 0% of codes.

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

About 18% below.

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

CPT 27447 (Total knee arthroplasty), at 108% of the South 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.

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