What does aetna pay neurology groups in GA?

Median published rate is 88% of Medicare across 180 NPIs (September 2026 files).

Data as of the September 2026 payer files.

Across 200 procedure codes and 1 payer, the median published rate is 41 percent of locality-adjusted Medicare in the September 2026 payer files. Aetna is the only payer with enough confirmed NPIs to publish here, at 41 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 180 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

What does aetna pay neurology groups in GA?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
Aetna	99214	professional	180	36	80.6	166.13	88%
Aetna	99213	professional	142	33.15	72.98	119.17	91.4%
Aetna	99204	professional	138	36	118.19	254.13	104.8%
Aetna	99215	professional	116	36	111.16	231.91	86.4%
Aetna	99205	professional	98	36	129.27	319.66	92.4%
Aetna	95816	professional	86	102.03	282.91	519.08	151.3%
Aetna	95886	professional	86	50.66	80.75	117.46	155.8%
Aetna	95819	professional	57	107.29	304.27	706.29	164.1%
Aetna	64615	professional	44	28.27	94.9	141.33	160.1%
Aetna	95911	professional	44	110.89	188.62	264.99	162.3%
Aetna	99203	professional	42	35.03	71.06	143.51	87.8%
Aetna	95910	professional	41	92.26	157.93	210.79	156%
Aetna	95885	professional	33	30.9	47.61	80.88	156.1%
Aetna	95909	professional	32	71.61	116.76	169.41	155.5%
Aetna	95913	professional	25	149.33	284.03	455.3	196.7%
Aetna	64616	professional	22	21.73	66.89	101.95	160.9%
Aetna	70551	professional	20	98.57	233.61	425	301.1%
Aetna	95720	professional	19	94.86	227.64	227.64	108.6%
Aetna	95874	professional	19	47.49	85.73	146.09	198.5%
Aetna	99483	professional	17	188.18	229.91	582.8	74.3%
Aetna	95718	professional	16	61.82	148.35	148.35	107.1%
Aetna	95813	professional	16	164.31	304.53	612.28	153.8%
Aetna	64612	professional	15	25.63	64.07	96.11	169.2%
Aetna	95912	professional	14	118.36	178.58	290.6	133.8%
Aetna	96138	professional	14	7.63	17.86	39.29	109.4%
Aetna	20610	professional	13	8.44	28.13	42.04	144.5%
Aetna	64405	professional	13	13.1	32.75	49.59	160.1%
Aetna	64483	professional	13	27.85	37.13	136.68	42.7%
Aetna	99212	professional	13	27	30	56.7	83.2%
Aetna	20553	professional	12	8.08	26.88	40.31	163.4%
Aetna	64493	professional	12	103.78	136.39	149.21	30%
Aetna	64635	professional	12	49.69	165.64	248.45	36.9%
Aetna	64642	professional	12	19.7	65.65	98.51	141.1%
Aetna	95908	professional	12	61.94	109.61	146.19	158.8%
Aetna	20552	professional	11	7.09	23.62	35.42	167.5%
Aetna	61624	professional	11	119.99	239.97	875.54	9.4%
Aetna	62270	professional	11	14.89	30	74.34	25.6%
Aetna	62321	professional	11	29.07	81.87	146.03	50.3%
Aetna	62323	professional	11	28.27	83.09	141.33	48.6%
Aetna	63650	professional	11	138.06	276.12	966.41	27.4%
Aetna	64490	professional	11	115.83	152.88	159.43	31.8%
Aetna	64644	professional	11	22.56	67.98	112.82	126.6%
Aetna	70553	professional	11	108.24	340	680.15	308.8%
Aetna	72141	professional	11	103.16	212.5	378.9	303.9%
Aetna	93880	professional	11	45.81	109.95	217.66	131.2%
Aetna	95822	professional	11	117.88	195.52	870.6	249.8%
Aetna	95938	professional	11	77.94	167.55	472.83	145.7%
Aetna	96132	professional	11	24.6	60.36	117.21	127.4%
Aetna	10005	professional	10	13.91	44.11	74.59	26.5%
Aetna	10021	professional	10	12.18	30	54.57	122.5%
Aetna	11640	professional	10	26.56	71.42	107.12	113.5%
Aetna	11641	professional	10	30	78.89	127.01	121.2%
Aetna	11642	professional	10	30	89.34	145.35	127.7%
Aetna	11643	professional	10	35.05	108.87	175.25	139.6%
Aetna	14040	professional	10	81.54	280.58	441.73	59%
Aetna	14041	professional	10	93.19	347.42	538.36	71.9%
Aetna	14060	professional	10	78.58	291.26	457.18	60.6%
Aetna	14061	professional	10	99.94	371.98	579.03	75.8%
Aetna	15823	professional	10	65.98	250.32	384.93	50.3%
Aetna	19296	professional	10	244.26	1264.71	1547.06	42.6%
Aetna	19298	professional	10	85.13	425.65	567.53	10.9%
Aetna	20526	professional	10	10.59	30	52.72	135.7%
Aetna	20550	professional	10	7.3	24.33	36.49	146.4%
Aetna	20551	professional	10	7.43	24.76	37.11	147.5%
Aetna	20600	professional	10	6.74	22.48	33.71	139.5%
Aetna	20604	professional	10	9.77	28.97	48.87	119.1%
Aetna	20605	professional	10	7.01	23.36	35.03	143.5%
Aetna	20606	professional	10	10.89	32.43	54.47	125.8%
Aetna	20611	professional	10	12.23	37.04	61.15	127.2%
Aetna	20680	professional	10	69.63	202.3	383.35	42.8%
Aetna	21315	professional	10	32.13	94.55	162.67	34.4%
Aetna	21320	professional	10	30	75.28	145.79	13.8%
Aetna	21555	professional	10	49.71	144.18	274.45	51.6%
Aetna	22510	professional	10	181.54	605.12	867.35	73.6%
Aetna	22511	professional	10	179.08	596.92	853.94	72.6%
Aetna	22513	professional	10	554.1	1787.35	2591.51	96.8%
Aetna	22514	professional	10	549.6	1772.1	2568.26	97.4%
Aetna	22551	professional	10	1221.62	1307.34	1743.12	19.4%
Aetna	22558	professional	10	175.7	645.61	1129.54	7.8%
Aetna	22600	professional	10	146.29	532.41	962.38	10.1%
Aetna	22612	professional	10	182.16	670.13	1148.94	12.1%
Aetna	22630	professional	10	178.02	646.97	1144.33	7.8%
Aetna	22633	professional	10	285.9	950.49	1421.96	9.1%
Aetna	22800	professional	10	179.06	630.04	1027.15	10.3%
Aetna	22802	professional	10	280.54	984.85	1525.09	15.6%
Aetna	22804	professional	10	323.2	1087.86	1756.2	17.9%
Aetna	22810	professional	10	274.31	965.2	1502.73	15.3%
Aetna	22812	professional	10	290.72	1023.04	1587.87	16.2%
Aetna	22849	professional	10	149.56	548.67	973.75	14.6%
Aetna	22850	professional	10	84.01	297.09	545.33	20.4%
Aetna	22852	professional	10	81.93	283.22	524.35	19.6%
Aetna	22855	professional	10	127.46	469.77	825.75	30.8%
Aetna	22856	professional	10	1170.99	1253.26	1671.01	12.8%
Aetna	22861	professional	10	1653.55	1771.67	2362.22	20.2%
Aetna	23472	professional	10	167.46	619.87	1042.73	10.7%
Aetna	24500	professional	10	44.28	126.51	257.45	265.7%
Aetna	24505	professional	10	64.01	183.69	355.77	56.8%
Aetna	25600	professional	10	39.01	103.78	243.73	252.5%
Aetna	25605	professional	10	75.43	234.45	392.37	62.5%
Aetna	25607	professional	10	533.22	571.31	759.59	15.3%
Aetna	25608	professional	10	596.41	639.01	852.01	17.1%
Aetna	25609	professional	10	757.23	811.31	1079.69	21.6%
Aetna	26055	professional	10	56.55	161.56	324.57	52.4%
Aetna	26160	professional	10	58.9	168.28	342.58	55.2%
Aetna	26600	professional	10	38.69	102.18	216.64	224.2%
Aetna	27130	professional	10	155.66	596.74	958.59	13.8%
Aetna	27134	professional	10	219.39	807.28	1376.1	21.1%
Aetna	27236	professional	10	134.94	490.54	888.95	25.1%
Aetna	27245	professional	10	139.84	511.7	914.08	26.1%
Aetna	27278	professional	10	936.79	1868.76	4379.76	40.2%
Aetna	27279	professional	10	132.89	442.07	663.1	6.1%
Aetna	27280	professional	10	139.8	420.92	978.62	10.1%
Aetna	27446	professional	10	127.93	457.06	860.57	12.9%
Aetna	27447	professional	10	161.78	638.07	973.47	14.1%
Aetna	27486	professional	10	159.61	582.66	1046.94	21.2%
Aetna	27487	professional	10	200.44	734.43	1263.82	12.9%
Aetna	27750	professional	10	44.94	124.69	246.45	256.7%
Aetna	27752	professional	10	69.88	203.28	383.46	61.1%
Aetna	27786	professional	10	40.85	112.98	223.93	231.1%
Aetna	27808	professional	10	41.82	117.81	238.01	246%
Aetna	27816	professional	10	42.49	112.43	226.67	238.9%
Aetna	28470	professional	10	31.1	78.89	156.07	161.3%
Aetna	29805	professional	10	60.38	214.29	355.53	29.6%
Aetna	29806	professional	10	119.51	433.8	787.69	29.5%
Aetna	29807	professional	10	116.56	422.34	769.57	28.8%
Aetna	29819	professional	10	75.69	268.47	444.76	36.9%
Aetna	29820	professional	10	69.68	246.73	407.38	15%
Aetna	29821	professional	10	76.44	271.3	449.89	37.4%
Aetna	29822	professional	10	74.14	231.32	403.5	34%
Aetna	29823	professional	10	77.45	253.34	441.76	37.2%
Aetna	29824	professional	10	80.21	271.76	503.79	42.5%
Aetna	29825	professional	10	74.84	235.95	438.02	36.9%
Aetna	29827	professional	10	121.49	443.08	796.74	29.8%
Aetna	29828	professional	10	661.25	708.48	943.71	25.6%
Aetna	29870	professional	10	66.12	195.2	360.15	30.6%
Aetna	29873	professional	10	70.26	205.42	397.6	33.6%
Aetna	29874	professional	10	71.95	216.68	400.58	33.7%
Aetna	29875	professional	10	67.87	198.81	369.8	31.2%
Aetna	29876	professional	10	79.04	263.95	486.71	41%
Aetna	29877	professional	10	76.91	249.73	462.8	39%
Aetna	29879	professional	10	79.5	267.02	492.77	41.5%
Aetna	29880	professional	10	81.24	278.64	424.52	35.3%
Aetna	29881	professional	10	78.47	260.17	403.75	34%
Aetna	29882	professional	10	81.7	281.67	514.81	43.3%
Aetna	29888	professional	10	111.17	405.68	728.63	20.9%
Aetna	29889	professional	10	137.54	497.2	881.68	12.7%
Aetna	29891	professional	10	81.48	280.21	499.02	42%
Aetna	29894	professional	10	65.98	231.74	376.97	31.2%
Aetna	29895	professional	10	65.87	199.31	348.18	29.2%
Aetna	29914	professional	10	718.4	769.72	1025.7	27.8%
Aetna	29915	professional	10	736.06	788.64	1050.95	28.5%
Aetna	29916	professional	10	736.13	788.72	1051.02	28.5%
Aetna	30115	professional	10	61.5	166.67	385.88	36.4%
Aetna	30130	professional	10	54.04	144.92	345.35	33.8%
Aetna	30140	professional	10	37.75	129.95	202.44	19.5%
Aetna	30420	professional	10	177.4	546.11	1202.37	53%
Aetna	30450	professional	10	216.33	614.92	1467.93	64.7%
Aetna	30465	professional	10	125.52	390.05	849.08	41.4%
Aetna	30468	professional	10	250.22	728.74	1251.12	39.8%
Aetna	30469	professional	10	219.27	638.62	1096.33	36.2%
Aetna	30520	professional	10	81.5	239.75	555.75	55%
Aetna	30801	professional	10	30.68	78.89	156.78	32.9%
Aetna	30802	professional	10	36.5	91.22	201.76	44.5%
Aetna	30903	professional	10	29.43	39.23	134.23	255.1%
Aetna	30905	professional	10	30	55.91	192.29	364.4%
Aetna	30906	professional	10	30.58	58.46	209.18	225.8%
Aetna	31231	professional	10	23.43	31.23	107.56	136.5%
Aetna	31237	professional	10	31.78	50.49	170.27	29.9%
Aetna	31238	professional	10	32.59	45.66	171.21	30.2%
Aetna	31239	professional	10	80	270.35	499.28	41.6%
Aetna	31240	professional	10	29.19	36.5	128.66	22.8%
Aetna	31253	professional	10	83.04	245.84	450.08	24.8%
Aetna	31254	professional	10	41.49	78.89	279.9	16.9%
Aetna	31255	professional	10	39.97	78.89	262.55	16%
Aetna	31256	professional	10	30	44.43	146.27	12.9%
Aetna	31257	professional	10	73.97	218.92	401.01	22.1%
Aetna	31259	professional	10	78.35	231.95	424.61	23.4%
Aetna	31267	professional	10	34.65	57.38	215.19	13.2%
Aetna	31276	professional	10	46.73	85.51	306.77	18.8%
Aetna	31287	professional	10	30	49.57	163.09	10%
Aetna	31288	professional	10	33.68	57.86	190.22	11.6%
Aetna	31295	professional	10	844.53	946.37	1126.04	36.3%
Aetna	31296	professional	10	876.59	1151.81	1219.71	79.3%
Aetna	31297	professional	10	844.54	1110.52	1172.67	36.7%
Aetna	31298	professional	10	321.22	870.44	1584.09	86.2%
Aetna	31535	professional	10	30	46.37	152.99	13.5%
Aetna	31536	professional	10	30	51.43	169.58	15%
Aetna	31540	professional	10	30.38	59.21	195.02	16.4%
Aetna	31541	professional	10	32.97	64.6	212.67	18.7%
Aetna	31575	professional	10	17.56	30	80.1	123.7%
Aetna	31576	professional	10	30	46.82	160.23	26.5%
Aetna	31577	professional	10	30	50.07	170.49	111.2%
Aetna	31578	professional	10	30	51.86	185.03	15.3%
Aetna	31579	professional	10	28.7	38.27	129.48	151.2%
Aetna	31600	professional	10	38.32	76.65	250.59	25.4%
Aetna	32555	professional	10	39.63	120.37	198.12	76.7%
Aetna	33206	professional	10	68.55	209.08	367.13	7.1%
Aetna	33207	professional	10	72.74	223.57	386.49	7.2%
Aetna	33208	professional	10	75.72	241.83	419.73	7.6%
Aetna	33212	professional	10	48.11	165.42	261.62	5.5%

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