Aetna negotiated rates in Washington
How Aetna's Washington rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Washington at a glance
What the data shows
Aetna ranks 4th of 4 payers in Washington with a rate index of 91 (100 = the Washington market median), across 228 procedure codes.
Aetna has the highest median for only 19% of codes in Washington; UnitedHealthcare leads with an index of 106 in the files analyzed.
Aetna's Washington rates sit 42% above its own national level, the 3rd highest of its 51 states.
Largest premium over the Washington market: CPT 72158 (Mri lumbar spine w/o & w/dye) at 125% of market; largest discount: CPT 11102 (Tangntl bx skin single les) at 48%.
How the four payers compare in Washington
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 106 | 1 | 60% | 695 | |
| Cigna | 99 | 2 | 13% | 749 | |
| Blue Cross Blue Shield | 98 | 3 | 8% | 799 | |
| Aetna | 91 | 4 | 19% | 708 |
Where Aetna pays most and least against the Washington market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 72158 Mri lumbar spine w/o & w/dye | $920 | $734 | +25% | 99 |
| 72141 Mri neck spine w/o dye | $562 | $451 | +25% | 99 |
| 72197 Mri pelvis w/o & w/dye | $979 | $803 | +22% | 99 |
| 93296 Rem interrog evl pm/ids | $61 | $50 | +21% | 86 |
| 72131 Ct lumbar spine w/o dye | $367 | $305 | +20% | 99 |
| 72125 Ct neck spine w/o dye | $369 | $307 | +20% | 99 |
| 55866 Laps surg prst8ect rpbic rad | $3,027 | $2,522 | +20% | 70 |
| 70450 Ct head/brain w/o dye | $290 | $245 | +19% | 99 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 11102 Tangntl bx skin single les | $54 | $112 | -52% | 84 |
| 99487 Cplx chrnc care 1st 60 min | $93 | $191 | -52% | 60 |
| 11104 Punch bx skin single lesion | $68 | $139 | -51% | 84 |
| 93297 Rem interrog dev eval icpms | $42 | $83 | -49% | 37 |
| 11301 Shave skin lesion 0.6-1.0 cm | $73 | $141 | -48% | 83 |
| 11302 Shave skin lesion 1.1-2.0 cm | $86 | $163 | -47% | 81 |
| 99348 Home/res vst est low mdm 30 | $92 | $163 | -44% | 28 |
| 99426 Prin care mgmt staff 1st 30 | $59 | $104 | -43% | 24 |
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 Washington?
Aetna ranks 4th of 4 in Washington with an index of 91. It is highest on 19% of codes.
Are Aetna's Washington rates above or below its national level?
About 42% above.
Which procedure does Aetna pay most above market in Washington?
CPT 72158 (Mri lumbar spine w/o & w/dye), at 125% of the Washington 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 Washington?
Compare your negotiated rates for these codes with Washington medians for each payer.