What does aetna pay cardiology groups in CA?
Median published rate is 69.8% of Medicare across 1500 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 200 procedure codes and 1 payer, the median published rate is 99 percent of locality-adjusted Medicare in the September 2026 payer files. Aetna is the only payer with enough confirmed NPIs to publish here, at 99 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 1500 confirmed NPIs, and any combination under five is withheld rather than shown thin. These are contracted amounts the payer published, not what a practice was paid, and every row clears the ghost-rate filter, so each NPI counted here actually billed the code in the Medicare utilization file.
Published rates
| Payer | Code | Site | n | p25 | p50 | p75 | % of Medicare |
|---|---|---|---|---|---|---|---|
| Aetna | 99214 | professional | 1500 | 40.54 | 61.91 | 110.8 | 69.8% |
| Aetna | 93306 | professional | 1408 | 95.65 | 195.4 | 263.27 | 119.8% |
| Aetna | 93000 | professional | 1314 | 9.86 | 19.71 | 24.15 | 127.5% |
| Aetna | 99204 | professional | 1130 | 41 | 74.47 | 163.78 | 82.3% |
| Aetna | 99215 | professional | 931 | 41 | 76.67 | 158.49 | 68.7% |
| Aetna | 99213 | professional | 873 | 31.52 | 54.94 | 76.86 | 67.9% |
| Aetna | 93010 | professional | 800 | 4.58 | 9.15 | 11.78 | 112.9% |
| Aetna | 93458 | professional | 773 | 533.52 | 943.74 | 1273.5 | 110.4% |
| Aetna | 99205 | professional | 685 | 41 | 93.76 | 231.38 | 79.8% |
| Aetna | 93015 | professional | 634 | 46.82 | 93.64 | 106.26 | 124.4% |
| Aetna | 93280 | professional | 617 | 33.31 | 44.38 | 67.41 | 97.6% |
| Aetna | 93325 | professional | 574 | 6.47 | 33.75 | 41.56 | 142.4% |
| Aetna | 92928 | professional | 571 | 121.03 | 535.44 | 960.62 | 114.6% |
| Aetna | 78452 | professional | 543 | 96.68 | 433.43 | 519.69 | 107% |
| Aetna | 93880 | professional | 533 | 40 | 162.49 | 209.86 | 99.9% |
| Aetna | 93351 | professional | 531 | 130.3 | 212.41 | 288.55 | 114.4% |
| Aetna | 93248 | professional | 517 | 13.83 | 28.77 | 36.16 | 124.9% |
| Aetna | 93294 | professional | 509 | 34.35 | 39.74 | 48.91 | 122.4% |
| Aetna | 93018 | professional | 467 | 8 | 15.58 | 19.75 | 118.7% |
| Aetna | 93320 | professional | 446 | 25.54 | 48.83 | 70.43 | 126% |
| Aetna | 33208 | professional | 440 | 73.45 | 390.26 | 1018.27 | 49.8% |
| Aetna | 93308 | professional | 435 | 39.97 | 76.86 | 124.75 | 118% |
| Aetna | 93454 | professional | 427 | 649.04 | 974.84 | 1370.88 | 110% |
| Aetna | 93246 | professional | 406 | 9.05 | 17.12 | 21.86 | 134.5% |
| Aetna | 93460 | professional | 396 | 897.01 | 1267 | 1773.5 | 110.5% |
| Aetna | 93656 | professional | 383 | 624.34 | 1197.95 | 1926.36 | 14% |
| Aetna | 93228 | professional | 376 | 25.4 | 28.77 | 35.32 | 104% |
| Aetna | 93016 | professional | 370 | 12.18 | 23.06 | 29.4 | 115.1% |
| Aetna | 93312 | professional | 352 | 66.09 | 168.93 | 293.5 | 138.6% |
| Aetna | 93244 | professional | 335 | 12.57 | 25.55 | 33.07 | 121.1% |
| Aetna | 93653 | professional | 330 | 543 | 1055 | 1929 | 11.1% |
| Aetna | 33228 | professional | 317 | 225.21 | 615.5 | 1586.25 | 22.2% |
| Aetna | 93459 | professional | 316 | 919.48 | 1285.26 | 1845 | 110.4% |
| Aetna | 33249 | professional | 312 | 180.37 | 992.04 | 1688 | 8.2% |
| Aetna | 92960 | professional | 299 | 39.55 | 82.13 | 176.61 | 115.4% |
| Aetna | 93229 | professional | 298 | 735.33 | 827.04 | 1048.11 | 91.6% |
| Aetna | 93295 | professional | 297 | 64.15 | 70.97 | 93.4 | 187.7% |
| Aetna | 33274 | professional | 295 | 362.54 | 976.5 | 2030.75 | 10.9% |
| Aetna | 92920 | professional | 288 | 390.17 | 1196 | 2200 | 45.9% |
| Aetna | 93455 | professional | 283 | 970.81 | 1353.77 | 2407.67 | 99.2% |
| Aetna | 33264 | professional | 279 | 270.73 | 928.72 | 1901.63 | 5.5% |
| Aetna | 93456 | professional | 279 | 986.94 | 1347.54 | 2397 | 98.8% |
| Aetna | 36569 | professional | 278 | 98.68 | 794.75 | 1546 | 168.2% |
| Aetna | 36589 | professional | 278 | 91.2 | 704 | 1397.5 | 303.4% |
| Aetna | 93650 | professional | 278 | 296.7 | 1101 | 2162 | 28.4% |
| Aetna | 93970 | professional | 278 | 39.01 | 162.49 | 205.66 | 104.2% |
| Aetna | 14040 | professional | 277 | 388.95 | 853.98 | 1536.75 | 105.4% |
| Aetna | 14041 | professional | 277 | 452.36 | 993.5 | 1760 | 115.1% |
| Aetna | 14060 | professional | 277 | 401.17 | 883.5 | 1747 | 112.4% |
| Aetna | 14061 | professional | 277 | 468.07 | 997.5 | 1760 | 115.2% |
| Aetna | 15823 | professional | 277 | 286.34 | 923.5 | 1989 | 124.6% |
| Aetna | 20610 | professional | 277 | 46.3 | 736.5 | 1397.5 | 2705.4% |
| Aetna | 20680 | professional | 277 | 304.07 | 829.5 | 1781.75 | 102.1% |
| Aetna | 21320 | professional | 277 | 114.35 | 789 | 1543.5 | 80.3% |
| Aetna | 21555 | professional | 277 | 212.95 | 787 | 1571.54 | 160% |
| Aetna | 25605 | professional | 277 | 329.11 | 822.5 | 1717 | 141.9% |
| Aetna | 25607 | professional | 277 | 901.63 | 1278.75 | 2554.75 | 28.7% |
| Aetna | 25608 | professional | 277 | 958.22 | 1287.75 | 2554.75 | 28.7% |
| Aetna | 25609 | professional | 277 | 995.13 | 1302.6 | 2554.75 | 28.8% |
| Aetna | 26055 | professional | 277 | 253.41 | 787 | 1543.5 | 136% |
| Aetna | 26160 | professional | 277 | 262.97 | 829.5 | 1751.5 | 144.4% |
| Aetna | 27750 | professional | 277 | 207.06 | 721 | 1432.5 | 778% |
| Aetna | 27752 | professional | 277 | 324.01 | 810.15 | 1472 | 124.4% |
| Aetna | 27786 | professional | 277 | 169.26 | 704.5 | 1400.5 | 777.3% |
| Aetna | 27816 | professional | 277 | 191.43 | 734.5 | 1444.5 | 782.8% |
| Aetna | 29806 | professional | 277 | 518.92 | 1013 | 1901 | 37% |
| Aetna | 29807 | professional | 277 | 507.46 | 1012.5 | 1886 | 36.9% |
| Aetna | 29821 | professional | 277 | 380.23 | 933.55 | 1826.25 | 83% |
| Aetna | 29822 | professional | 277 | 315.48 | 853.98 | 1901.5 | 81.9% |
| Aetna | 29823 | professional | 277 | 344.18 | 880 | 1907.5 | 83% |
| Aetna | 29824 | professional | 277 | 380.21 | 970 | 2069.25 | 89.6% |
| Aetna | 29825 | professional | 277 | 357.4 | 864.5 | 1892.38 | 83% |
| Aetna | 29827 | professional | 277 | 526.92 | 1138.5 | 2129.25 | 41.1% |
| Aetna | 29870 | professional | 277 | 306.98 | 832.5 | 1895.38 | 77.5% |
| Aetna | 29873 | professional | 277 | 298.37 | 883.5 | 1901 | 83% |
| Aetna | 29874 | professional | 277 | 339.34 | 880 | 1827.5 | 83% |
| Aetna | 29875 | professional | 277 | 279.25 | 902 | 1988.5 | 84.7% |
| Aetna | 29876 | professional | 277 | 368.06 | 917 | 2003.25 | 84.7% |
| Aetna | 29877 | professional | 277 | 349.65 | 917 | 1988.5 | 86.7% |
| Aetna | 29879 | professional | 277 | 372.28 | 883.5 | 1899 | 82.3% |
| Aetna | 29880 | professional | 277 | 378 | 917 | 1988.5 | 86.7% |
| Aetna | 29881 | professional | 277 | 353.97 | 917 | 1988.5 | 87.7% |
| Aetna | 29882 | professional | 277 | 389.58 | 880 | 1885.75 | 83% |
| Aetna | 29888 | professional | 277 | 486.52 | 1012.5 | 2007.75 | 28.5% |
| Aetna | 29891 | professional | 277 | 383.5 | 883.5 | 1784.25 | 79% |
| Aetna | 30115 | professional | 277 | 278.19 | 797 | 1598.64 | 80.3% |
| Aetna | 30140 | professional | 277 | 243.47 | 787 | 1543.5 | 80.2% |
| Aetna | 30420 | professional | 277 | 683 | 1176 | 2239.5 | 59.6% |
| Aetna | 30520 | professional | 277 | 371.02 | 902 | 1916.75 | 92.3% |
| Aetna | 30801 | professional | 277 | 105.97 | 732 | 1417.5 | 161% |
| Aetna | 30802 | professional | 277 | 137.91 | 732 | 1459.87 | 163.1% |
| Aetna | 30903 | professional | 277 | 70.2 | 765.25 | 1464.8 | 1432.6% |
| Aetna | 31237 | professional | 277 | 128.78 | 846.5 | 1668.75 | 140.7% |
| Aetna | 31240 | professional | 277 | 78.16 | 864.5 | 1679.5 | 142.6% |
| Aetna | 31255 | professional | 277 | 192.59 | 1000.25 | 2182.25 | 58.3% |
| Aetna | 31256 | professional | 277 | 96.03 | 898.75 | 1826.88 | 75.1% |
| Aetna | 31267 | professional | 277 | 153.06 | 898.75 | 1861.25 | 52% |
| Aetna | 31276 | professional | 277 | 242.32 | 898.75 | 1825 | 52% |
| Aetna | 31288 | professional | 277 | 130.12 | 902 | 1827.5 | 53.1% |
| Aetna | 31535 | professional | 277 | 92.32 | 864.5 | 1679.5 | 70.9% |
| Aetna | 31536 | professional | 277 | 102.92 | 902 | 1825 | 76.6% |
| Aetna | 31541 | professional | 277 | 128.52 | 986.5 | 2038.88 | 81.3% |
| Aetna | 33213 | professional | 277 | 249.92 | 849 | 1803.5 | 17.8% |
| Aetna | 36561 | professional | 277 | 455.79 | 990 | 1764 | 84.1% |
| Aetna | 36581 | professional | 277 | 296.95 | 804.1 | 1571.54 | 57.7% |
| Aetna | 36590 | professional | 277 | 146.96 | 721 | 1435.75 | 164.1% |
| Aetna | 38500 | professional | 277 | 181.07 | 791.75 | 1583.05 | 74.2% |
| Aetna | 38505 | professional | 277 | 53.15 | 779.75 | 1471.06 | 142.1% |
| Aetna | 38510 | professional | 277 | 263.3 | 787 | 1571.54 | 74.1% |
| Aetna | 42145 | professional | 277 | 453.9 | 1067.75 | 2012 | 53.7% |
| Aetna | 42405 | professional | 277 | 177.62 | 834 | 1645.25 | 183.5% |
| Aetna | 42415 | professional | 277 | 602.08 | 1275 | 2190.74 | 54% |
| Aetna | 42420 | professional | 277 | 676 | 1321 | 2209 | 56.7% |
| Aetna | 42810 | professional | 277 | 221.46 | 832.5 | 1777 | 87.8% |
| Aetna | 42820 | professional | 277 | 173.62 | 832 | 1760 | 42.9% |
| Aetna | 42821 | professional | 277 | 180.81 | 947 | 2008 | 97.5% |
| Aetna | 42825 | professional | 277 | 178.66 | 900 | 1939 | 45.6% |
| Aetna | 42826 | professional | 277 | 151.47 | 896 | 1898.75 | 92.3% |
| Aetna | 42830 | professional | 277 | 125.52 | 896 | 1885.05 | 92.3% |
| Aetna | 42831 | professional | 277 | 145.79 | 899.5 | 1937.5 | 93.1% |
| Aetna | 42835 | professional | 277 | 121.39 | 991.5 | 2163.25 | 104.7% |
| Aetna | 43200 | professional | 277 | 93.48 | 794.75 | 1502.5 | 218.1% |
| Aetna | 43202 | professional | 277 | 116.35 | 796.5 | 1505 | 121.4% |
| Aetna | 43235 | professional | 277 | 127.04 | 779.75 | 1471.06 | 213.1% |
| Aetna | 43236 | professional | 277 | 156.78 | 847.5 | 1650 | 236.8% |
| Aetna | 43237 | professional | 277 | 126.16 | 862 | 1650 | 132.9% |
| Aetna | 43239 | professional | 277 | 147.72 | 805 | 1586 | 234.4% |
| Aetna | 43241 | professional | 277 | 83.5 | 869 | 1668 | 132.9% |
| Aetna | 43242 | professional | 277 | 226.02 | 854.75 | 1636 | 132.9% |
| Aetna | 43244 | professional | 277 | 158.31 | 841.5 | 1636 | 132.6% |
| Aetna | 43245 | professional | 277 | 100.34 | 863.25 | 1646.5 | 132.9% |
| Aetna | 43246 | professional | 277 | 133.59 | 846.5 | 1646.5 | 132.8% |
| Aetna | 43247 | professional | 277 | 107.15 | 841.5 | 1621.89 | 235.6% |
| Aetna | 43248 | professional | 277 | 101.48 | 846.5 | 1621.89 | 235.6% |
| Aetna | 43249 | professional | 277 | 93.55 | 841.5 | 1621.89 | 132.6% |
| Aetna | 43251 | professional | 277 | 116.6 | 841.5 | 1668.75 | 132.6% |
| Aetna | 43255 | professional | 277 | 151.22 | 841.5 | 1636 | 132.6% |
| Aetna | 43259 | professional | 277 | 162.73 | 898.75 | 1782.63 | 141.8% |
| Aetna | 43260 | professional | 277 | 185.36 | 864.5 | 1679.5 | 60.6% |
| Aetna | 43261 | professional | 277 | 194.81 | 846.5 | 1668.75 | 59.8% |
| Aetna | 43262 | professional | 277 | 228.54 | 846.5 | 1668.75 | 59.8% |
| Aetna | 43264 | professional | 277 | 274.16 | 848.1 | 1668.75 | 59.8% |
| Aetna | 43265 | professional | 277 | 307.2 | 869 | 1679.5 | 42.7% |
| Aetna | 45331 | professional | 277 | 72.13 | 779.75 | 1447.25 | 206.6% |
| Aetna | 45334 | professional | 277 | 88.05 | 796.5 | 1552 | 167.4% |
| Aetna | 45335 | professional | 277 | 101.65 | 783 | 1472 | 207.8% |
| Aetna | 45338 | professional | 277 | 132.5 | 781.5 | 1471.06 | 161.6% |
| Aetna | 45378 | professional | 277 | 147.71 | 764 | 1526 | 231% |
| Aetna | 45380 | professional | 277 | 206.5 | 805 | 1586 | 179.5% |
| Aetna | 45381 | professional | 277 | 199.89 | 834 | 1586 | 179.5% |
| Aetna | 45382 | professional | 277 | 268.77 | 846.5 | 1623.92 | 180.8% |
| Aetna | 45384 | professional | 277 | 206.27 | 845.5 | 1650 | 180.8% |
| Aetna | 45385 | professional | 277 | 235.49 | 805 | 1586 | 179.5% |
| Aetna | 45386 | professional | 277 | 268.53 | 866.75 | 1656.25 | 181% |
| Aetna | 45391 | professional | 277 | 485.5 | 1061 | 1894 | 184.2% |
| Aetna | 47000 | professional | 277 | 131.54 | 781.5 | 1471.88 | 143% |
| Aetna | 50200 | professional | 277 | 223.24 | 796.5 | 1472 | 143% |
| Aetna | 51715 | professional | 277 | 141.95 | 900.5 | 1819.63 | 53.6% |
| Aetna | 52000 | professional | 277 | 98.67 | 765.25 | 1471.88 | 339.1% |
| Aetna | 52005 | professional | 277 | 126.67 | 846.5 | 1678.38 | 118.7% |
| Aetna | 52204 | professional | 277 | 172.01 | 854.75 | 1668.75 | 118.7% |
| Aetna | 52214 | professional | 277 | 257.52 | 869 | 1679.5 | 69.8% |
| Aetna | 52224 | professional | 277 | 289.14 | 869 | 1679.5 | 69.8% |
| Aetna | 52234 | professional | 277 | 137.7 | 864.5 | 1679.5 | 70.2% |
| Aetna | 52235 | professional | 277 | 161.16 | 900.5 | 1825 | 75.4% |
| Aetna | 52240 | professional | 277 | 280.04 | 900.5 | 1825 | 47.6% |
| Aetna | 52260 | professional | 277 | 117.3 | 869 | 1735 | 120.7% |
| Aetna | 52276 | professional | 277 | 148.45 | 901.5 | 1825 | 127.2% |
| Aetna | 52281 | professional | 277 | 129.9 | 846.5 | 1678.38 | 118.5% |
| Aetna | 52310 | professional | 277 | 117.04 | 846.5 | 1678.38 | 118.5% |
| Aetna | 52315 | professional | 277 | 206.37 | 854.75 | 1678.38 | 118.7% |
| Aetna | 52317 | professional | 277 | 379.96 | 891 | 1568 | 63.8% |
| Aetna | 52318 | professional | 277 | 263.01 | 846.5 | 1678.38 | 68.9% |
| Aetna | 52332 | professional | 277 | 199.43 | 846.5 | 1668.75 | 69% |
| Aetna | 52344 | professional | 277 | 213.5 | 906 | 1825 | 75.5% |
| Aetna | 52351 | professional | 277 | 175.85 | 898.75 | 1798.88 | 73.6% |
| Aetna | 52352 | professional | 277 | 206.5 | 975.25 | 2023.38 | 79.2% |
| Aetna | 52353 | professional | 277 | 236.84 | 981.5 | 2051.63 | 50.5% |
| Aetna | 52601 | professional | 277 | 469.88 | 1040 | 1938.5 | 50% |
| Aetna | 54100 | professional | 277 | 93.27 | 779.75 | 1530 | 143.7% |
| Aetna | 54150 | professional | 277 | 74.3 | 779.75 | 1530 | 106.4% |
| Aetna | 54161 | professional | 277 | 120.68 | 789 | 1615.5 | 120.1% |
| Aetna | 54162 | professional | 277 | 165.42 | 797 | 1631 | 120.1% |
| Aetna | 54520 | professional | 277 | 221.44 | 832.5 | 1782.63 | 75.4% |
| Aetna | 54530 | professional | 277 | 310.21 | 902 | 1937 | 78.3% |
| Aetna | 54640 | professional | 277 | 322.64 | 899 | 1937.5 | 78.3% |
| Aetna | 54840 | professional | 277 | 230.99 | 900 | 1938 | 137.6% |
| Aetna | 55040 | professional | 277 | 207.67 | 832.5 | 1764 | 73.1% |
| Aetna | 55041 | professional | 277 | 364.08 | 1037.16 | 2046 | 82.7% |
| Aetna | 55250 | professional | 277 | 202.99 | 787 | 1571.54 | 118.5% |
| Aetna | 55705 | professional | 277 | 192.29 | 847.5 | 1600 | 70.2% |
| Aetna | 57240 | professional | 277 | 376.93 | 995 | 2008 | 62.9% |
| Aetna | 57250 | professional | 277 | 423.99 | 980 | 2012 | 62.9% |
| Aetna | 57260 | professional | 277 | 476.5 | 1053.61 | 2012 | 62.9% |
| Aetna | 57265 | professional | 277 | 476.5 | 1160.96 | 2201.86 | 71.1% |
| Aetna | 57288 | professional | 277 | 405.89 | 990 | 1994.5 | 48% |
| Aetna | 62225 | professional | 277 | 317.02 | 831 | 1472 | 49.9% |
| Aetna | 62230 | professional | 277 | 465 | 893.95 | 1635.75 | 29.1% |
| Aetna | 62270 | professional | 277 | 61.92 | 754.75 | 1401.5 | 271.9% |
| Aetna | 62272 | professional | 277 | 74.06 | 779.75 | 1471.63 | 272.2% |
Median rate by payer, percent of Medicare
Solid line 100% of Medicare.
How this is measured
Rates come from each payer's published Transparency in Coverage machine-readable file, filtered to this specialty's codes and to NPIs the CMS Medicare utilization file shows billing that code. Percentiles are computed per payer, code and site of service across those NPIs, then divided by the locality-adjusted Medicare amount for the same code and place. Full methodology.
- Payer files: 2026-09
Questions
Is this what the practice was paid?
No. These are contracted rates as published by the payer, not allowed or paid amounts.
Why are some cells blank?
Ghost rates are removed using Medicare utilization. A row appears only if that NPI billed the code.
What is an episode total?
Professional plus facility when both exist. We never average them or invent a total from one side.
Saran Siva
Co-founder & CTO, Insight Health · September 2026 files