Aetna negotiated rates in Wisconsin
How Aetna's Wisconsin rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.
Aetna in Wisconsin at a glance
What the data shows
Aetna ranks 4th of 4 payers in Wisconsin with a rate index of 51 (100 = the Wisconsin market median), across 225 procedure codes.
Aetna has the highest median for only 0% of codes in Wisconsin; UnitedHealthcare leads with an index of 125 in the files analyzed.
Aetna's Wisconsin rates sit 2% below its own national level, the 27th highest of its 51 states.
Largest premium over the Wisconsin market: CPT 88313 (Special stains group 2) at 102% of market; largest discount: CPT 64566 (Neuroeltrd stim post tibial) at 23%.
How the four payers compare in Wisconsin
| Payer | Index | Rank | Level | Highest on | Providers |
|---|---|---|---|---|---|
| UnitedHealthcare | 125 | 1 | 57% | 610 | |
| Blue Cross Blue Shield | 114 | 2 | 42% | 733 | |
| Cigna | 67 | 3 | 1% | 296 | |
| Aetna | 51 | 4 | 0% | 291 |
Where Aetna pays most and least against the Wisconsin market
Highest above market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 88313 Special stains group 2 | $94 | $92 | +2% | 31 |
| 88312 Special stains group 1 | $130 | $129 | +1% | 55 |
| 74183 Mri abd w/o cntr flwd cntr | $821 | $821 | +0% | 47 |
| 70553 Mri brain stem w/o & w/dye | $771 | $785 | -2% | 48 |
| 73221 Mri joint upr extrem w/o dye | $489 | $500 | -2% | 71 |
| 93229 Remote 30 day ecg tech supp | $1,603 | $1,653 | -3% | 22 |
| 73721 Mri jnt of lwr extre w/o dye | $488 | $504 | -3% | 71 |
| 72148 Mri lumbar spine w/o dye | $461 | $481 | -4% | 72 |
Furthest below market
| Code | Aetna | Market | Gap | Prov. |
|---|---|---|---|---|
| 64566 Neuroeltrd stim post tibial | $27 | $119 | -77% | 29 |
| 52224 Cystoscopy and treatment | $202 | $800 | -75% | 28 |
| 51720 Treatment of bladder lesion | $44 | $167 | -74% | 26 |
| 51702 Insert temp bladder cath | $25 | $96 | -74% | 34 |
| 51700 Irrigation of bladder | $30 | $114 | -74% | 30 |
| 52332 Cystoscopy and treatment | $156 | $576 | -73% | 34 |
| 17004 Destroy premal lesions 15/> | $96 | $343 | -72% | 22 |
| 52281 Cystoscopy and treatment | $152 | $540 | -72% | 28 |
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 Wisconsin?
Aetna ranks 4th of 4 in Wisconsin with an index of 51. It is highest on 0% of codes.
Are Aetna's Wisconsin rates above or below its national level?
About 2% below.
Which procedure does Aetna pay most above market in Wisconsin?
CPT 88313 (Special stains group 2), at 102% of the Wisconsin 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 Wisconsin?
Compare your negotiated rates for these codes with Wisconsin medians for each payer.