What does aetna pay orthopedics groups in CO?
Median published rate is 87.4% of Medicare across 313 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 200 procedure codes and 1 payer, the median published rate is 144 percent of locality-adjusted Medicare in the September 2026 payer files. Aetna is the only payer with enough confirmed NPIs to publish here, at 144 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 313 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 | 99213 | professional | 313 | 33.24 | 74.11 | 90.97 | 87.4% |
| Aetna | 99214 | professional | 308 | 47.72 | 110.1 | 134.56 | 88.3% |
| Aetna | 99204 | professional | 247 | 59.55 | 154.4 | 201.26 | 91.8% |
| Aetna | 99203 | professional | 235 | 34.79 | 91.57 | 123.03 | 87.4% |
| Aetna | 20610 | professional | 211 | 11 | 53.41 | 80.73 | 114.3% |
| Aetna | 73030 | professional | 112 | 15.16 | 35.15 | 47 | 137.8% |
| Aetna | 73564 | professional | 109 | 18.43 | 47.94 | 66.54 | 141.8% |
| Aetna | 27447 | professional | 101 | 259.7 | 959.5 | 2021.29 | 164.7% |
| Aetna | 73502 | professional | 101 | 18.19 | 55.1 | 71.92 | 143.5% |
| Aetna | 73562 | professional | 101 | 15.25 | 42.23 | 57 | 140.6% |
| Aetna | 99212 | professional | 98 | 20.69 | 44.52 | 53.96 | 80.7% |
| Aetna | 27130 | professional | 89 | 261.93 | 990.6 | 2030.27 | 163.2% |
| Aetna | 20550 | professional | 66 | 9.68 | 44.3 | 68.71 | 110.5% |
| Aetna | 73721 | professional | 62 | 135.34 | 292.53 | 500 | 180.4% |
| Aetna | 20600 | professional | 60 | 8.94 | 33.63 | 63.49 | 109.8% |
| Aetna | 20605 | professional | 56 | 9.21 | 45.71 | 65.52 | 112% |
| Aetna | 23472 | professional | 54 | 1080.11 | 2044.99 | 2392.22 | 156.7% |
| Aetna | 29827 | professional | 49 | 544.97 | 1415.19 | 1756.99 | 154.7% |
| Aetna | 20611 | professional | 47 | 21.7 | 109.82 | 127.04 | 115.1% |
| Aetna | 99215 | professional | 47 | 60.14 | 157.58 | 184.38 | 89.8% |
| Aetna | 64721 | professional | 46 | 222.22 | 419.66 | 634.44 | 127.3% |
| Aetna | 26055 | professional | 45 | 90.09 | 337.83 | 639.61 | 97% |
| Aetna | 72100 | professional | 43 | 17.98 | 37.56 | 55.52 | 146.2% |
| Aetna | 63047 | professional | 42 | 542.02 | 1316.43 | 1803.44 | 148.1% |
| Aetna | 73221 | professional | 40 | 158.12 | 378.73 | 657.08 | 224.9% |
| Aetna | 72110 | professional | 36 | 22.05 | 55.24 | 78.44 | 144.6% |
| Aetna | 73110 | professional | 36 | 12.58 | 35.33 | 48.45 | 124.6% |
| Aetna | 73130 | professional | 33 | 12.21 | 31.71 | 49.13 | 140.6% |
| Aetna | 73610 | professional | 33 | 14.01 | 38.27 | 49.14 | 140.5% |
| Aetna | 29823 | professional | 32 | 214.38 | 545.92 | 1102.88 | 154.1% |
| Aetna | 73630 | professional | 31 | 13.49 | 29.29 | 45.31 | 137.7% |
| Aetna | 22633 | professional | 29 | 853.22 | 2135.4 | 3327.61 | 126.8% |
| Aetna | 22612 | professional | 28 | 784.34 | 1690.34 | 2614.43 | 89.2% |
| Aetna | 22853 | professional | 28 | 94.07 | 337.67 | 389.8 | 164.8% |
| Aetna | 29826 | professional | 28 | 84.2 | 244.18 | 301.47 | 192.3% |
| Aetna | 72148 | professional | 28 | 142.52 | 252.02 | 483.44 | 202.2% |
| Aetna | 29828 | professional | 27 | 1258.32 | 1508.45 | 2593.55 | 118.6% |
| Aetna | 20526 | professional | 26 | 86.18 | 110.19 | 1196.38 | 412.4% |
| Aetna | 27245 | professional | 26 | 611.12 | 1219.35 | 2028.93 | 90.7% |
| Aetna | 22558 | professional | 25 | 755.33 | 1354 | 2482.4 | 47.6% |
| Aetna | 64718 | professional | 25 | 166.7 | 454.63 | 982.38 | 146.8% |
| Aetna | 22842 | professional | 24 | 148.13 | 896.16 | 1162.9 | 175% |
| Aetna | 73560 | professional | 24 | 13.33 | 28.86 | 43.82 | 145.1% |
| Aetna | 22551 | professional | 23 | 1262.03 | 2439.92 | 4496 | 106% |
| Aetna | 27236 | professional | 22 | 577.12 | 1034.96 | 1640.48 | 89.8% |
| Aetna | 20680 | professional | 21 | 120.01 | 392.16 | 976.18 | 125.5% |
| Aetna | 22614 | professional | 21 | 75.96 | 451.26 | 570.22 | 167.1% |
| Aetna | 20604 | professional | 20 | 22.65 | 76.54 | 1030.25 | 1602.3% |
| Aetna | 27487 | professional | 19 | 626.5 | 1350.46 | 2892.17 | 85.5% |
| Aetna | 29824 | professional | 18 | 540.05 | 1258 | 3866.45 | 175.1% |
| Aetna | 29880 | professional | 18 | 471.39 | 1162 | 3630.95 | 166.7% |
| Aetna | 29881 | professional | 18 | 234.53 | 449.69 | 2087.62 | 210.4% |
| Aetna | 20606 | professional | 17 | 35.43 | 171.65 | 2050.73 | 2046.2% |
| Aetna | 22600 | professional | 17 | 537.35 | 996.93 | 2664.5 | 34.3% |
| Aetna | 27280 | professional | 17 | 879.28 | 1964.88 | 4382.5 | 31.7% |
| Aetna | 27446 | professional | 17 | 772.33 | 1741.72 | 4341.95 | 47.1% |
| Aetna | 63048 | professional | 17 | 92.72 | 284.69 | 333.4 | 172.5% |
| Aetna | 64483 | professional | 17 | 233.69 | 685.25 | 2860.45 | 243.4% |
| Aetna | 73080 | professional | 17 | 12.21 | 27.71 | 38.93 | 134.8% |
| Aetna | 26160 | professional | 16 | 367.29 | 1050.25 | 3353.95 | 173% |
| Aetna | 27279 | professional | 16 | 573.16 | 1244.5 | 4341.95 | 29.9% |
| Aetna | 63030 | professional | 16 | 641.98 | 1273.73 | 3866.45 | 104.6% |
| Aetna | 63655 | professional | 16 | 621.86 | 1297.5 | 4496 | 31.2% |
| Aetna | 63685 | professional | 16 | 276.76 | 1066.5 | 3161.95 | 11.5% |
| Aetna | 20551 | professional | 15 | 52.74 | 876.75 | 3161.59 | 3696.8% |
| Aetna | 22849 | professional | 15 | 810 | 1812 | 4143.95 | 45% |
| Aetna | 22856 | professional | 15 | 1241 | 3019.52 | 9569.5 | 34.3% |
| Aetna | 25609 | professional | 15 | 1211 | 2060.5 | 4382.5 | 77.1% |
| Aetna | 27486 | professional | 15 | 810 | 1812 | 4496 | 66.1% |
| Aetna | 64450 | professional | 15 | 42.56 | 874.5 | 2860.45 | 2282.1% |
| Aetna | 72141 | professional | 15 | 196.53 | 356.33 | 525 | 183.9% |
| Aetna | 99205 | professional | 15 | 90.32 | 223.58 | 276.91 | 92.2% |
| Aetna | 10005 | professional | 14 | 175 | 1118.5 | 3095.73 | 527.8% |
| Aetna | 10021 | professional | 14 | 127.81 | 879 | 3095.73 | 3232.6% |
| Aetna | 11640 | professional | 14 | 125.33 | 1127.25 | 3204.21 | 1636.4% |
| Aetna | 11641 | professional | 14 | 148.84 | 1127.25 | 3204.21 | 1466.5% |
| Aetna | 11642 | professional | 14 | 170.31 | 1127.25 | 3204.21 | 1346.7% |
| Aetna | 11643 | professional | 14 | 205.07 | 1127.25 | 3204.21 | 1214.4% |
| Aetna | 14040 | professional | 14 | 465.15 | 1127.25 | 3204.21 | 205.7% |
| Aetna | 14041 | professional | 14 | 564.8 | 1158.5 | 3331 | 226.4% |
| Aetna | 14060 | professional | 14 | 487.37 | 1158.5 | 3331 | 226.4% |
| Aetna | 14061 | professional | 14 | 598.37 | 1158.5 | 3331 | 226.4% |
| Aetna | 15823 | professional | 14 | 442.84 | 1244.5 | 3331 | 247.5% |
| Aetna | 19296 | professional | 14 | 1241 | 2268 | 3331 | 74.5% |
| Aetna | 19298 | professional | 14 | 810 | 2237.5 | 3331 | 48.5% |
| Aetna | 20552 | professional | 14 | 66.19 | 879 | 3462.73 | 7272.1% |
| Aetna | 20553 | professional | 14 | 76.23 | 879 | 3462.73 | 6233.2% |
| Aetna | 21315 | professional | 14 | 79.79 | 1127.25 | 3381.84 | 352.5% |
| Aetna | 21320 | professional | 14 | 115.63 | 981.25 | 3381.84 | 156.8% |
| Aetna | 21555 | professional | 14 | 276.6 | 981.25 | 3204.21 | 312.8% |
| Aetna | 22510 | professional | 14 | 650.58 | 1205.5 | 4616.46 | 198.8% |
| Aetna | 22511 | professional | 14 | 649.05 | 1205.5 | 4616.46 | 198.8% |
| Aetna | 22513 | professional | 14 | 1115.88 | 2082.55 | 4616.46 | 95.7% |
| Aetna | 22514 | professional | 14 | 1115.88 | 2072.64 | 4616.46 | 95.7% |
| Aetna | 22630 | professional | 14 | 801.49 | 1583 | 4732 | 18.7% |
| Aetna | 22800 | professional | 14 | 778.29 | 1418.5 | 4467.96 | 27.5% |
| Aetna | 22802 | professional | 14 | 985.01 | 1524.01 | 4467.96 | 26.6% |
| Aetna | 22804 | professional | 14 | 1100.06 | 1735.29 | 4467.96 | 26.6% |
| Aetna | 22810 | professional | 14 | 950.11 | 1489.11 | 4467.96 | 26.6% |
| Aetna | 22812 | professional | 14 | 1022.12 | 1584.61 | 4467.96 | 26.6% |
| Aetna | 22850 | professional | 14 | 546.46 | 1583 | 4732 | 91.8% |
| Aetna | 22852 | professional | 14 | 526.31 | 1583 | 4467.96 | 93% |
| Aetna | 22855 | professional | 14 | 735.55 | 1583 | 4467.96 | 93% |
| Aetna | 22861 | professional | 14 | 1450.75 | 2270.25 | 5440 | 27.6% |
| Aetna | 24500 | professional | 14 | 268.26 | 998.75 | 3240.96 | 1513% |
| Aetna | 24505 | professional | 14 | 329.55 | 998.75 | 3240.96 | 235% |
| Aetna | 25600 | professional | 14 | 261.71 | 876.75 | 3240.96 | 1513% |
| Aetna | 25605 | professional | 14 | 394.8 | 1068.77 | 3611.09 | 294% |
| Aetna | 25607 | professional | 14 | 1093.38 | 2132.75 | 4382.5 | 61.1% |
| Aetna | 25608 | professional | 14 | 1093.38 | 2132.75 | 4382.5 | 61% |
| Aetna | 26600 | professional | 14 | 204.64 | 1197.5 | 3331 | 1873.7% |
| Aetna | 27134 | professional | 14 | 909.99 | 1613.49 | 6355.88 | 41.6% |
| Aetna | 27278 | professional | 14 | 1226 | 2726.5 | 3331 | 20.1% |
| Aetna | 27750 | professional | 14 | 261.23 | 998.75 | 3240.96 | 1513% |
| Aetna | 27752 | professional | 14 | 345.74 | 998.75 | 3240.96 | 235% |
| Aetna | 27786 | professional | 14 | 233.6 | 876.75 | 3240.96 | 1513% |
| Aetna | 27808 | professional | 14 | 251.08 | 998.75 | 3240.96 | 1513% |
| Aetna | 27816 | professional | 14 | 244.2 | 876.75 | 3240.96 | 1513% |
| Aetna | 28470 | professional | 14 | 164.24 | 998.75 | 3161.59 | 1513% |
| Aetna | 29805 | professional | 14 | 354.67 | 1158.5 | 3531.71 | 163.8% |
| Aetna | 29806 | professional | 14 | 614.51 | 1197.5 | 3611.09 | 72.9% |
| Aetna | 29807 | professional | 14 | 611.47 | 1197.5 | 3611.09 | 72.3% |
| Aetna | 29819 | professional | 14 | 412.86 | 1197.5 | 3531.71 | 156.9% |
| Aetna | 29820 | professional | 14 | 394.53 | 1158.5 | 3611.09 | 72.9% |
| Aetna | 29821 | professional | 14 | 417.05 | 1158.5 | 3531.71 | 163.8% |
| Aetna | 29822 | professional | 14 | 395.94 | 1197.5 | 3531.71 | 156.9% |
| Aetna | 29825 | professional | 14 | 413.08 | 1158.5 | 3531.71 | 156.9% |
| Aetna | 29870 | professional | 14 | 365.89 | 1073.96 | 3531.71 | 156.9% |
| Aetna | 29873 | professional | 14 | 395.79 | 1197.5 | 3531.71 | 156.9% |
| Aetna | 29874 | professional | 14 | 394.67 | 1197.5 | 3531.71 | 163.8% |
| Aetna | 29875 | professional | 14 | 373.66 | 1205.5 | 3739.46 | 173.9% |
| Aetna | 29876 | professional | 14 | 480.14 | 1205.5 | 3739.46 | 173.9% |
| Aetna | 29877 | professional | 14 | 465.65 | 1205.5 | 3739.46 | 173.9% |
| Aetna | 29879 | professional | 14 | 452.47 | 1158.5 | 3531.71 | 156.9% |
| Aetna | 29882 | professional | 14 | 465.81 | 1197.5 | 3531.71 | 156.9% |
| Aetna | 29888 | professional | 14 | 603.64 | 1197.5 | 3611.09 | 55.9% |
| Aetna | 29889 | professional | 14 | 635.6 | 1158.5 | 3611.09 | 27.2% |
| Aetna | 29891 | professional | 14 | 458.65 | 1158.5 | 3531.71 | 156.9% |
| Aetna | 29894 | professional | 14 | 377.94 | 1197.5 | 3531.71 | 163.8% |
| Aetna | 29895 | professional | 14 | 343.11 | 1197.5 | 3531.71 | 156.9% |
| Aetna | 29914 | professional | 14 | 1052.93 | 2002.5 | 4382.5 | 77.5% |
| Aetna | 29915 | professional | 14 | 1056.47 | 2002.5 | 4382.5 | 77.5% |
| Aetna | 29916 | professional | 14 | 1056.74 | 2002.5 | 4382.5 | 77.5% |
| Aetna | 30115 | professional | 14 | 383.91 | 1127.25 | 3381.84 | 165.8% |
| Aetna | 30130 | professional | 14 | 369.7 | 1158.5 | 3525.84 | 182% |
| Aetna | 30140 | professional | 14 | 208.22 | 981.25 | 3381.84 | 156.8% |
| Aetna | 30420 | professional | 14 | 828.99 | 1267.87 | 3910.21 | 102% |
| Aetna | 30450 | professional | 14 | 1010.11 | 1533.24 | 4041.5 | 105% |
| Aetna | 30465 | professional | 14 | 826.84 | 1456.25 | 4041.5 | 104.9% |
| Aetna | 30468 | professional | 14 | 847.09 | 1505 | 4041.5 | 79.4% |
| Aetna | 30469 | professional | 14 | 834.41 | 1505 | 4041.5 | 81.8% |
| Aetna | 30520 | professional | 14 | 543.93 | 1205.5 | 3733.59 | 193.3% |
| Aetna | 30801 | professional | 14 | 163.89 | 998.75 | 3155.71 | 311.1% |
| Aetna | 30802 | professional | 14 | 212.04 | 876.75 | 3155.71 | 311.1% |
| Aetna | 30903 | professional | 14 | 206.97 | 879 | 3450.98 | 2788.6% |
| Aetna | 30905 | professional | 14 | 237.12 | 1118.5 | 3450.98 | 2788.6% |
| Aetna | 30906 | professional | 14 | 249.53 | 1118.5 | 3450.98 | 1583.6% |
| Aetna | 31231 | professional | 14 | 237.65 | 983.5 | 3601.73 | 2115.2% |
| Aetna | 31237 | professional | 14 | 275.54 | 983.5 | 3601.73 | 275.1% |
| Aetna | 31238 | professional | 14 | 275.22 | 983.5 | 3601.73 | 275.1% |
| Aetna | 31239 | professional | 14 | 500.79 | 1205.5 | 3733.59 | 174.9% |
| Aetna | 31240 | professional | 14 | 250.93 | 1223 | 3601.73 | 275.1% |
| Aetna | 31253 | professional | 14 | 492.52 | 1248 | 3953.98 | 123.9% |
| Aetna | 31254 | professional | 14 | 394.29 | 1170 | 3836.23 | 113.1% |
| Aetna | 31255 | professional | 14 | 415.6 | 1248 | 3953.98 | 123.9% |
| Aetna | 31256 | professional | 14 | 279.12 | 1241 | 3697.73 | 151.3% |
| Aetna | 31257 | professional | 14 | 468.99 | 1248 | 3953.98 | 123.9% |
| Aetna | 31259 | professional | 14 | 480.33 | 1248 | 3953.98 | 123.9% |
| Aetna | 31267 | professional | 14 | 315.78 | 1241 | 3697.73 | 104.7% |
| Aetna | 31276 | professional | 14 | 365.06 | 1241 | 3697.73 | 104.7% |
| Aetna | 31287 | professional | 14 | 287.99 | 1241 | 3697.73 | 104.7% |
| Aetna | 31288 | professional | 14 | 302.29 | 1241 | 3697.73 | 104.7% |
| Aetna | 31295 | professional | 14 | 1050.25 | 1974.47 | 4041.5 | 85.8% |
| Aetna | 31296 | professional | 14 | 1050.25 | 1989.92 | 4041.5 | 178.6% |
| Aetna | 31297 | professional | 14 | 1050.25 | 1966.04 | 4041.5 | 85.5% |
| Aetna | 31298 | professional | 14 | 829.46 | 1460.87 | 3836.23 | 128% |
| Aetna | 31535 | professional | 14 | 264.07 | 1271 | 3601.73 | 144.7% |
| Aetna | 31536 | professional | 14 | 291.91 | 1241 | 3697.73 | 151.3% |
| Aetna | 31540 | professional | 14 | 305.49 | 1241 | 3697.73 | 158.8% |
| Aetna | 31541 | professional | 14 | 358.13 | 1241 | 3836.23 | 168.6% |
| Aetna | 31575 | professional | 14 | 180.21 | 983.5 | 3601.73 | 2505.1% |
| Aetna | 31576 | professional | 14 | 267.4 | 1271 | 3601.73 | 275.4% |
| Aetna | 31577 | professional | 14 | 270.71 | 1271 | 3601.73 | 1081.6% |
| Aetna | 31578 | professional | 14 | 281.8 | 1271 | 3601.73 | 137% |
| Aetna | 31579 | professional | 14 | 251.25 | 1271 | 3601.73 | 1836% |
| Aetna | 31600 | professional | 14 | 312.61 | 1271 | 3601.73 | 165.8% |
| Aetna | 32555 | professional | 14 | 228.61 | 1118.5 | 3095.73 | 595.1% |
| Aetna | 33206 | professional | 14 | 380.05 | 1456.25 | 5266.34 | 52.6% |
| Aetna | 33207 | professional | 14 | 398.88 | 1456.25 | 5266.34 | 44.1% |
| Aetna | 33208 | professional | 14 | 430.57 | 1456.25 | 5266.34 | 43.1% |
| Aetna | 33212 | professional | 14 | 271.49 | 1158.5 | 4506.21 | 42.5% |
| Aetna | 33213 | professional | 14 | 282.51 | 1158.5 | 4506.21 | 36.9% |
| Aetna | 33214 | professional | 14 | 400.06 | 1456.25 | 5266.34 | 50.2% |
| Aetna | 33216 | professional | 14 | 311.51 | 1205.5 | 4713.96 | 50.2% |
| Aetna | 33217 | professional | 14 | 309.71 | 1205.5 | 4713.96 | 45.7% |
| Aetna | 33224 | professional | 14 | 413.83 | 1241 | 5658.48 | 36.8% |
| Aetna | 33226 | professional | 14 | 404.54 | 1241 | 4398.48 | 131.2% |
| Aetna | 33227 | professional | 14 | 283.74 | 1158.5 | 3331 | 41.7% |
| Aetna | 33228 | professional | 14 | 296.82 | 1158.5 | 4506.21 | 35.7% |
| Aetna | 33229 | professional | 14 | 311.34 | 1158.5 | 4506.21 | 20.9% |
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