What does aetna pay orthopedics groups in GA?

Median published rate is 101.9% of Medicare across 556 NPIs (September 2026 files).

Data as of the September 2026 payer files.

Across 200 procedure codes and 1 payer, the median published rate is 110 percent of locality-adjusted Medicare in the September 2026 payer files. Aetna is the only payer with enough confirmed NPIs to publish here, at 110 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 556 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 orthopedics groups in GA?
Payer	Code	Site	n	p25	p50	p75	% of Medicare
Aetna	99213	professional	556	36	73.51	119.36	101.9%
Aetna	99214	professional	515	44.01	109.16	176.55	101.2%
Aetna	20610	professional	460	27.73	46.58	83.1	142.4%
Aetna	99203	professional	432	39.47	92.1	160.32	105.2%
Aetna	99204	professional	403	43.8	152.31	254.13	107.7%
Aetna	73030	professional	311	18.37	33.36	48.05	158.1%
Aetna	73502	professional	261	20.66	41.93	65.12	158.8%
Aetna	27447	professional	237	146.51	923.84	2262.82	196.9%
Aetna	73562	professional	208	18.37	39	56.98	164%
Aetna	72100	professional	205	20.66	36	54.45	157.8%
Aetna	73564	professional	197	22.85	43.5	63.88	161.8%
Aetna	20550	professional	174	19.73	41.83	78.89	158.4%
Aetna	27130	professional	169	148.52	926.08	2261.92	179.6%
Aetna	73721	professional	166	93.73	340	570.84	287.5%
Aetna	99212	professional	159	35.9	49.4	78.89	97.8%
Aetna	20600	professional	150	17.24	43.09	78.89	169.3%
Aetna	73130	professional	141	16.44	33	50.7	157.1%
Aetna	20605	professional	136	19.89	40.85	78.89	176.8%
Aetna	73110	professional	135	19.19	36.52	57.68	151.3%
Aetna	73221	professional	121	93.73	338.86	520.09	275.8%
Aetna	72040	professional	111	21.56	35.82	52.28	151.8%
Aetna	73610	professional	109	16.6	35.26	51.33	152.8%
Aetna	26055	professional	108	71.24	343.1	740.7	127%
Aetna	20611	professional	106	18.14	105.29	209.05	201.2%
Aetna	23472	professional	106	223.24	1116.19	2227.22	86.3%
Aetna	73560	professional	106	15.04	31.58	45.14	150.6%
Aetna	72148	professional	104	93.77	309.28	564.71	303.7%
Aetna	73630	professional	104	15.94	33	47.57	153.2%
Aetna	29827	professional	102	171.73	825.41	1783.54	104.6%
Aetna	63047	professional	95	184.44	934.1	2020.5	114.5%
Aetna	64721	professional	94	72.77	339.57	806.06	137.4%
Aetna	20552	professional	93	23.46	41	78.2	264.9%
Aetna	27245	professional	89	220.97	980.34	1794.88	56%
Aetna	20526	professional	85	30	57.59	128.3	231.4%
Aetna	22612	professional	85	256.74	1379	2373.88	24.8%
Aetna	29824	professional	82	116.52	537.47	1159.38	143.2%
Aetna	27236	professional	78	204.37	953.74	1642.86	46.1%
Aetna	64483	professional	78	40.16	124.55	330.82	144.1%
Aetna	29823	professional	76	102.08	510.4	1208.1	112.4%
Aetna	22633	professional	73	427.94	1478	2521.39	13.1%
Aetna	29828	professional	72	1006.22	1353.91	1835.35	49.7%
Aetna	22551	professional	70	1388.87	2103.75	2985.89	31.5%
Aetna	22558	professional	70	260.77	1288.03	2248.93	12.5%
Aetna	64718	professional	70	98.96	478.68	985.8	129%
Aetna	73080	professional	67	19.19	36	54.9	174.8%
Aetna	29881	professional	66	102.57	465.64	1251.25	104.7%
Aetna	20551	professional	65	29.02	60.64	757.25	2275.8%
Aetna	29880	professional	64	96.74	483.68	1313.63	99.9%
Aetna	62323	professional	63	39.64	227.12	924	235.1%
Aetna	20604	professional	61	32.58	105.06	1024	1784.5%
Aetna	64493	professional	61	197.1	764	1243.5	197%
Aetna	20680	professional	60	83.84	400.59	1163.91	97.4%
Aetna	62321	professional	59	41.06	263.23	1011.63	238.5%
Aetna	63030	professional	59	209.66	863.63	1691.72	52.5%
Aetna	20606	professional	58	36.32	117.38	1024	1673.9%
Aetna	20553	professional	57	31.29	54.9	918.25	2808.5%
Aetna	25600	professional	57	56.39	263.15	750.5	681.7%
Aetna	25609	professional	57	1197.8	1492.81	2185.94	39.7%
Aetna	26160	professional	57	96.42	455.33	1164.56	139%
Aetna	64490	professional	57	224.02	887.5	1275	197%
Aetna	64635	professional	57	163.59	428.08	974.63	102.9%
Aetna	22513	professional	56	777.37	1847.01	2727.85	63.6%
Aetna	27279	professional	56	450.98	938.17	1642.63	10.8%
Aetna	27446	professional	56	255.38	982.94	1656.5	22.1%
Aetna	27487	professional	56	388.34	1446.5	2269.41	16.2%
Aetna	27786	professional	56	53.51	250.49	911	693.7%
Aetna	28470	professional	56	43.05	176.97	911	693.7%
Aetna	29879	professional	56	136.48	559.68	1311.34	86.3%
Aetna	63685	professional	56	84.63	455.35	1159.5	4.7%
Aetna	64450	professional	56	36.45	72.43	961.5	1777.3%
Aetna	64640	professional	56	41.34	191.54	932.13	515.5%
Aetna	64719	professional	56	83.73	445.86	1102.93	122.2%
Aetna	72110	professional	56	28.43	43.25	69.51	164.8%
Aetna	10005	professional	55	33.24	130.5	1024	251.3%
Aetna	11641	professional	55	41.39	174.17	1037.25	718.9%
Aetna	11642	professional	55	42.95	196.98	1144.13	672%
Aetna	11643	professional	55	48.61	232.6	1144.13	606%
Aetna	14040	professional	55	147.46	670.75	1159.5	102.7%
Aetna	14041	professional	55	187.47	787.5	1347.85	117%
Aetna	14060	professional	55	149.59	700.18	1291.41	107.5%
Aetna	14061	professional	55	201.79	787.5	1429.93	118.9%
Aetna	15823	professional	55	95.54	451.41	1363	120.8%
Aetna	21320	professional	55	42.01	194.86	1037.25	76.9%
Aetna	21555	professional	55	74.59	328.64	1144.13	156.3%
Aetna	22514	professional	55	768.87	1832.01	2704	61.1%
Aetna	22600	professional	55	290.47	1108.68	1872.58	16.1%
Aetna	22630	professional	55	323.32	1297.06	1945.49	10.7%
Aetna	25605	professional	55	90.9	444.58	1213.5	139%
Aetna	27134	professional	55	399.28	1497.73	2294.63	24.7%
Aetna	27486	professional	55	305.17	1201.68	1930.88	29.3%
Aetna	29806	professional	55	213.47	907.54	1601.41	45.8%
Aetna	29807	professional	55	216.56	854.24	1520.85	46.1%
Aetna	29822	professional	55	117.3	573.26	1222.5	79.7%
Aetna	29825	professional	55	121.44	519.28	1295.63	83.4%
Aetna	29873	professional	55	101.42	460.8	1213.5	79.7%
Aetna	29877	professional	55	128.26	548.63	1339	83.4%
Aetna	29888	professional	55	201.28	837.29	1497.5	34.7%
Aetna	31575	professional	55	37.65	123.42	1130.75	1229.4%
Aetna	32555	professional	55	85.91	367.48	1024	283.4%
Aetna	36561	professional	55	165.2	786.18	1216.23	75.4%
Aetna	36589	professional	55	39.74	142.31	984.25	297.2%
Aetna	38222	professional	55	43.41	177.95	1024	78.2%
Aetna	38510	professional	55	88.94	406.06	1144.13	72.3%
Aetna	43235	professional	55	47.92	270.52	971.5	196.1%
Aetna	43239	professional	55	55.49	335.63	1130.75	228.8%
Aetna	43249	professional	55	74.56	353.19	1159.5	129.7%
Aetna	45378	professional	55	83.19	228.47	1026.75	223.1%
Aetna	45380	professional	55	66.51	431.9	1130.75	173.4%
Aetna	45381	professional	55	66.88	426.08	1130.75	173.4%
Aetna	45385	professional	55	72.41	451.17	1130.75	173.4%
Aetna	50590	professional	55	130.8	626.87	2022.75	119.5%
Aetna	51715	professional	55	58.57	327.22	1213.5	51%
Aetna	51729	professional	55	309.05	613.89	1024	441.4%
Aetna	52000	professional	55	41.39	212.6	971.5	314.4%
Aetna	52005	professional	55	52.04	271.03	1130.75	113.7%
Aetna	52260	professional	55	41.39	245.99	1159.5	115.7%
Aetna	52276	professional	55	53.63	334.38	1213.5	121.1%
Aetna	52281	professional	55	55.04	315.76	1159.5	115.7%
Aetna	52310	professional	55	52.89	278.7	1130.75	113.7%
Aetna	52332	professional	55	61.69	373.12	1130.75	66.1%
Aetna	52352	professional	55	64.28	412.1	1339	77.7%
Aetna	52356	professional	55	155	583.95	1364.59	49.1%
Aetna	52601	professional	55	160.27	761.37	1339	50.6%
Aetna	52630	professional	55	98.8	533.51	1144.13	42.5%
Aetna	54150	professional	55	38.1	149.88	940.25	95.5%
Aetna	54161	professional	55	49.01	239.85	1089	115.7%
Aetna	54530	professional	55	119.94	572.37	1339	76.8%
Aetna	55250	professional	55	63.11	317.9	1089	115.7%
Aetna	57260	professional	55	129.26	646.29	1361.5	60.5%
Aetna	57282	professional	55	115.17	575.86	1351	42.5%
Aetna	57287	professional	55	153.39	750.35	1366.5	79.9%
Aetna	57288	professional	55	129.86	649.29	1360	46.1%
Aetna	63267	professional	55	299.55	1199.29	1844.3	52%
Aetna	63650	professional	55	317.32	1057.74	1545.68	29.8%
Aetna	63655	professional	55	190.35	847.5	1660.92	12.1%
Aetna	64445	professional	55	36.15	118.51	971.5	790.5%
Aetna	64615	professional	55	72.77	174.79	1015.75	1276%
Aetna	64633	professional	55	165.46	448.4	1015.75	102.9%
Aetna	64708	professional	55	104.87	441.02	1139	122.2%
Aetna	64910	professional	55	752.5	1109.89	1550	21%
Aetna	65855	professional	55	49.73	230.8	1145.5	876.4%
Aetna	66174	professional	55	880.64	1363	2065	75.2%
Aetna	66761	professional	55	55.66	272.79	921.13	500.7%
Aetna	66821	professional	55	74.56	290.7	999.88	377.3%
Aetna	66982	professional	55	167.48	761.83	1374.28	110.6%
Aetna	66984	professional	55	122.27	584.54	1363	109.2%
Aetna	66991	professional	55	275.5	850.76	1746.5	43.4%
Aetna	67800	professional	55	36.83	117.05	921.13	1197.1%
Aetna	68761	professional	55	36.83	135.41	921.13	1017.2%
Aetna	92928	professional	55	194.41	901.49	1817.5	23.2%
Aetna	93454	professional	55	689.33	1475	1883	106.1%
Aetna	93458	professional	55	797.65	1446.2	1938.79	110.3%
Aetna	93459	professional	55	863.59	1535.66	2015.21	112.6%
Aetna	93460	professional	55	958.43	1574.5	2108.5	122.6%
Aetna	10021	professional	54	35.7	105.77	1024	1614.1%
Aetna	11640	professional	54	40.21	149.3	1154.38	816.6%
Aetna	21315	professional	54	45.1	182.71	1159.5	175.9%
Aetna	22849	professional	54	268.23	1114.16	1875.9	20.7%
Aetna	22850	professional	54	167.42	753.78	1540.5	42.8%
Aetna	22852	professional	54	161.14	725.06	1540.5	42.8%
Aetna	22856	professional	54	1329.48	1801.25	2743.02	17.2%
Aetna	24500	professional	54	72.04	291.19	1024	755.5%
Aetna	25607	professional	54	831.17	1351	2143.5	31.5%
Aetna	25608	professional	54	938.41	1351	2143.5	32.9%
Aetna	27750	professional	54	69.58	281.15	999.75	755.5%
Aetna	29819	professional	54	125.46	525	1351.75	87.4%
Aetna	29870	professional	54	98.1	446.34	1213.5	74.9%
Aetna	29874	professional	54	114.67	525	1280.25	82.6%
Aetna	29875	professional	54	105.86	525	1355	90.1%
Aetna	29876	professional	54	145.29	656.42	1342.47	87.4%
Aetna	29882	professional	54	142.49	592.98	1328.57	85.9%
Aetna	29891	professional	54	153.86	657	1311	80.5%
Aetna	29914	professional	54	857.53	1339	1957.54	42.9%
Aetna	29916	professional	54	883.43	1339	1997.42	43.3%
Aetna	30115	professional	54	102.9	422.49	1159.5	78.3%
Aetna	30130	professional	54	90.49	375.74	1213.5	83.2%
Aetna	30140	professional	54	54.08	249.19	1122.5	78.3%
Aetna	30465	professional	54	251.04	1103	1849.46	60.2%
Aetna	30520	professional	54	172.55	799.33	1339	90.4%
Aetna	30802	professional	54	54.36	220.64	966.5	154.1%
Aetna	30903	professional	54	40.8	178.49	984.25	1348.9%
Aetna	30905	professional	54	45	286.69	1024	1392.4%
Aetna	31231	professional	54	39.18	173.93	1159.5	1056.7%
Aetna	31237	professional	54	46.07	282.88	1159.5	137.4%
Aetna	31238	professional	54	45.03	278.22	1159.5	137.4%
Aetna	31240	professional	54	40.64	194.63	1159.5	137.4%
Aetna	31253	professional	54	159.94	747.9	1653.63	56.3%
Aetna	31254	professional	54	78.44	483.93	1339	54.6%
Aetna	31255	professional	54	79.93	483.09	1389	56.3%
Aetna	31256	professional	54	43.05	235.86	1249.5	72.6%
Aetna	31257	professional	54	142.52	609.22	1653.63	56.3%
Aetna	31259	professional	54	150.9	705.67	1653.63	56.3%
Aetna	31267	professional	54	65.48	349.06	1249.5	50.3%
Aetna	31276	professional	54	81.81	525	1249.5	50.3%
Aetna	31287	professional	54	45	258.29	1249.5	50.3%
Aetna	31288	professional	54	50.72	304.09	1249.5	50.3%
Aetna	31295	professional	54	1062.12	1356.25	1943.35	47.9%
Aetna	31296	professional	54	1080.25	1356.25	1992.1	100.2%
Aetna	31297	professional	54	1043.17	1356.25	1949.43	47.8%
Aetna	31298	professional	54	448.07	1339	1989.75	79.5%

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