Aetna · Tennessee · commercial in-network

Aetna negotiated rates in Tennessee

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

Aetna in Tennessee at a glance

Across 228 procedure codes for 8 specialties
Rate index vs state market
82
18% below the Tennessee median
Rank in state
4 of 4
UHC 112 · BCBS 103 · Cigna 97 · Aetna 82
vs own national
100
Aetna's level vs its national median
Codes where highest
8%
of 228 codes
767 sampled providers587 TINs228 codesMedian 114% of Medicare · method

What the data shows

Generated from Tennessee and Aetna data only
1

Aetna ranks 4th of 4 payers in Tennessee with a rate index of 82 (100 = the Tennessee market median), across 228 procedure codes.

2

Aetna has the highest median for only 8% of codes in Tennessee; UnitedHealthcare leads with an index of 112 in the files analyzed.

3

Aetna's Tennessee rates sit 0% below its own national level, the 26th highest of its 51 states.

4

Largest premium over the Tennessee market: CPT 88342 (Imhchem/imcytchm 1st antb) at 147% of market; largest discount: CPT 99487 (Cplx chrnc care 1st 60 min) at 42%.

How the four payers compare in Tennessee

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
UnitedHealthcare1121
112
58%775
Blue Cross Blue Shield1032
103
18%844
Cigna973
97
16%850
Aetna824
82
8%767

Where Aetna pays most and least against the Tennessee market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
88342
Imhchem/imcytchm 1st antb
$87$59+47%79
88312
Special stains group 1
$92$64+43%138
70450
Ct head/brain w/o dye
$275$219+26%91
88305
Tissue exam by pathologist
$60$49+22%156
88313
Special stains group 2
$66$55+20%70
77280
Ther rad simulaj field smpl
$308$260+19%65
27236
Treat thigh fracture
$2,424$2,158+12%77
65820
Goniotomy
$992$892+11%81

Furthest below market

CodeAetnaMarketGapProv.
99487
Cplx chrnc care 1st 60 min
$48$114-58%32
77080
Dxa bone density axial
$36$64-44%91
45384
Colonoscopy w/lesion removal
$311$550-44%62
77049
Mri breast c-+ w/cad bi
$331$567-42%88
99490
Chrnc care mgmt staff 1st 20
$34$58-41%234
93229
Remote 30 day ecg tech supp
$645$1,060-39%42
93298
Rem interrog dev eval scrms
$28$46-39%90
74174
Cta abd&plvs w/contrast
$384$613-37%89

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 Tennessee?

Aetna ranks 4th of 4 in Tennessee with an index of 82. It is highest on 8% of codes.

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

About 0% below.

Which procedure does Aetna pay most above market in Tennessee?

CPT 88342 (Imhchem/imcytchm 1st antb), at 147% of the Tennessee 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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