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
What the data shows
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.
Aetna has the highest median for only 0% of codes in South Dakota; UnitedHealthcare leads with an index of 104 in the files analyzed.
Aetna's South Dakota rates sit 18% below its own national level, the 50th highest of its 51 states.
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
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 104 | 1 | 43% | 316 | |
| Cigna | 103 | 2 | 41% | 286 | |
| Blue Cross Blue Shield | 100 | 3 | 20% | 457 | |
| Aetna | 51 | 4 | 0% | 147 |
Where Aetna pays most and least against the South Dakota market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 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
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 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
- 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 South Dakota?
Compare your negotiated rates for these codes with South Dakota medians for each payer.