What does aetna pay orthopedics groups in TN?
Median published rate is 102.2% of Medicare across 475 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 200 procedure codes and 1 payer, the median published rate is 160 percent of locality-adjusted Medicare in the September 2026 payer files. Aetna is the only payer with enough confirmed NPIs to publish here, at 160 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 475 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 | 475 | 48 | 72.48 | 127.64 | 102.2% |
| Aetna | 99214 | professional | 449 | 53.17 | 107.44 | 188.29 | 105.4% |
| Aetna | 99204 | professional | 373 | 60.14 | 165.12 | 286.55 | 114.8% |
| Aetna | 20610 | professional | 348 | 21.66 | 55.67 | 89.87 | 139.5% |
| Aetna | 99203 | professional | 319 | 48 | 107.59 | 198.78 | 123.8% |
| Aetna | 73030 | professional | 248 | 15.23 | 28.42 | 48 | 137.4% |
| Aetna | 73502 | professional | 232 | 22.13 | 42.71 | 66.78 | 153.2% |
| Aetna | 73562 | professional | 200 | 18.34 | 36.66 | 58.11 | 140.1% |
| Aetna | 27447 | professional | 182 | 168.09 | 808.5 | 1923.14 | 210.4% |
| Aetna | 72100 | professional | 154 | 21.94 | 36.35 | 55.42 | 160.1% |
| Aetna | 73564 | professional | 153 | 21.94 | 44.41 | 65.72 | 144.7% |
| Aetna | 99212 | professional | 144 | 21.3 | 49.61 | 81.95 | 91.6% |
| Aetna | 73721 | professional | 131 | 114.27 | 334.12 | 963.49 | 291.5% |
| Aetna | 27130 | professional | 126 | 170.87 | 854.33 | 1958.04 | 198.3% |
| Aetna | 73130 | professional | 108 | 17.03 | 32.14 | 53.69 | 157.5% |
| Aetna | 73560 | professional | 105 | 14.15 | 29.2 | 48.89 | 139% |
| Aetna | 20550 | professional | 104 | 21.3 | 52.7 | 94.8 | 155% |
| Aetna | 73221 | professional | 97 | 133.89 | 348.09 | 963.49 | 299.9% |
| Aetna | 73610 | professional | 96 | 17.08 | 34.06 | 54.01 | 164.2% |
| Aetna | 72148 | professional | 91 | 119.39 | 327.12 | 963.49 | 320% |
| Aetna | 73110 | professional | 91 | 17.08 | 38.29 | 61.76 | 158.1% |
| Aetna | 99215 | professional | 90 | 62.13 | 128.43 | 208.68 | 104.3% |
| Aetna | 20605 | professional | 81 | 28.14 | 54.1 | 95.47 | 180.4% |
| Aetna | 72040 | professional | 80 | 22.13 | 41.02 | 57 | 199.1% |
| Aetna | 73630 | professional | 78 | 16.42 | 33.6 | 50.17 | 189.1% |
| Aetna | 23472 | professional | 70 | 214.21 | 963.42 | 1840.1 | 184.7% |
| Aetna | 20600 | professional | 68 | 27.62 | 52.05 | 91.85 | 153.7% |
| Aetna | 64721 | professional | 64 | 80.19 | 282.8 | 564.24 | 164.4% |
| Aetna | 26055 | professional | 56 | 83.02 | 292.1 | 677.4 | 148.7% |
| Aetna | 27245 | professional | 55 | 154.48 | 752.96 | 1158.62 | 177.2% |
| Aetna | 20611 | professional | 54 | 15.1 | 50.34 | 120.15 | 132% |
| Aetna | 29827 | professional | 54 | 165.56 | 772.59 | 1628.09 | 181.8% |
| Aetna | 29826 | professional | 50 | 43.77 | 109.43 | 228.54 | 202.9% |
| Aetna | 72110 | professional | 44 | 25.69 | 44.9 | 73.3 | 159.4% |
| Aetna | 27236 | professional | 42 | 150.24 | 663.34 | 1126.81 | 152.1% |
| Aetna | 73552 | professional | 42 | 17.94 | 33.6 | 49.54 | 150.8% |
| Aetna | 96372 | professional | 42 | 17.98 | 19.1 | 30.82 | 133% |
| Aetna | 97110 | professional | 41 | 45.24 | 45.62 | 45.62 | 164.9% |
| Aetna | 63047 | professional | 40 | 150.03 | 1000.19 | 2401.98 | 175.4% |
| Aetna | 99205 | professional | 39 | 67.27 | 95.6 | 390.31 | 178% |
| Aetna | 29823 | professional | 37 | 95.6 | 395.06 | 903.79 | 184.1% |
| Aetna | 22853 | professional | 34 | 44.67 | 167.52 | 383.25 | 196% |
| Aetna | 73080 | professional | 34 | 18.72 | 33.84 | 45.62 | 159.9% |
| Aetna | 97140 | professional | 34 | 42.01 | 42.01 | 42.01 | 159.2% |
| Aetna | 97530 | professional | 34 | 58.53 | 58.53 | 58.53 | 176.9% |
| Aetna | 20526 | professional | 33 | 43.17 | 70.75 | 142.98 | 176.9% |
| Aetna | 22612 | professional | 32 | 207.74 | 1164.83 | 2479.07 | 177.2% |
| Aetna | 29824 | professional | 32 | 104.79 | 426.73 | 853.45 | 180.9% |
| Aetna | 22842 | professional | 29 | 98.92 | 494.6 | 1074.27 | 194.9% |
| Aetna | 72141 | professional | 28 | 153.09 | 550 | 963.49 | 400.1% |
| Aetna | 97112 | professional | 28 | 52.91 | 52.91 | 52.91 | 169.9% |
| Aetna | 22633 | professional | 27 | 340.27 | 1206.18 | 2268.46 | 148.2% |
| Aetna | 29881 | professional | 26 | 100.38 | 394.37 | 686.07 | 155.5% |
| Aetna | 73501 | professional | 24 | 18.6 | 38.77 | 46.15 | 192.7% |
| Aetna | 20551 | professional | 23 | 9.24 | 39.41 | 57.53 | 138.1% |
| Aetna | 22840 | professional | 23 | 98.55 | 919.82 | 1417.54 | 221.4% |
| Aetna | 22558 | professional | 22 | 232.1 | 1003.61 | 2395.28 | 146% |
| Aetna | 29828 | professional | 21 | 928.17 | 1650 | 1998.42 | 119.9% |
| Aetna | 72070 | professional | 21 | 20.91 | 36.6 | 48 | 161.6% |
| Aetna | 22614 | professional | 20 | 67.63 | 253.6 | 483.16 | 190.7% |
| Aetna | 27487 | professional | 20 | 310.68 | 1165.04 | 3312.46 | 115.6% |
| Aetna | 64718 | professional | 20 | 116.41 | 591.97 | 1320.96 | 234% |
| Aetna | 27446 | professional | 19 | 276.86 | 1082.42 | 2181.52 | 116.3% |
| Aetna | 20552 | professional | 18 | 25.13 | 49.76 | 96.35 | 209.9% |
| Aetna | 22551 | professional | 18 | 1797.3 | 2797.81 | 3963.75 | 84.6% |
| Aetna | 26160 | professional | 18 | 94.21 | 420.46 | 715.42 | 137.7% |
| Aetna | 61783 | professional | 16 | 284.57 | 370.29 | 500.23 | 218% |
| Aetna | 20606 | professional | 15 | 17.87 | 68.66 | 123 | 215.8% |
| Aetna | 29880 | professional | 15 | 104.13 | 469.65 | 975.22 | 164.1% |
| Aetna | 63048 | professional | 15 | 95.1 | 212.04 | 317.96 | 188.3% |
| Aetna | 64483 | professional | 15 | 47.08 | 125.81 | 395.77 | 166% |
| Aetna | 20680 | professional | 14 | 96.39 | 326.37 | 796.14 | 190.6% |
| Aetna | 73565 | professional | 14 | 16.9 | 37.73 | 56.57 | 138.3% |
| Aetna | 25609 | professional | 13 | 985.94 | 2185.51 | 3409 | 77.1% |
| Aetna | 63052 | professional | 13 | 80.82 | 230.92 | 544.39 | 266% |
| Aetna | 62323 | professional | 12 | 59.77 | 192.07 | 1712.38 | 416.1% |
| Aetna | 64635 | professional | 12 | 160.93 | 331.09 | 1512.13 | 179.3% |
| Aetna | 20604 | professional | 11 | 16.04 | 62.31 | 1812.5 | 3312.3% |
| Aetna | 22600 | professional | 11 | 224.1 | 784.36 | 1120.52 | 28.3% |
| Aetna | 22845 | professional | 11 | 94.65 | 879.25 | 1137.31 | 195.1% |
| Aetna | 29822 | professional | 11 | 99.24 | 365.9 | 1322.7 | 154.9% |
| Aetna | 29879 | professional | 11 | 101.76 | 410.84 | 699.66 | 154.9% |
| Aetna | 64490 | professional | 11 | 237.68 | 1412 | 2836.5 | 373.3% |
| Aetna | 64493 | professional | 11 | 212.64 | 1412 | 2836.5 | 373.3% |
| Aetna | 64640 | professional | 11 | 48 | 163.42 | 265.2 | 919.9% |
| Aetna | 14040 | professional | 10 | 118.49 | 482.55 | 1679.25 | 227.3% |
| Aetna | 22514 | professional | 10 | 1050.58 | 2297.33 | 3396.99 | 102.3% |
| Aetna | 22630 | professional | 10 | 276.4 | 991.23 | 2066.26 | 19.3% |
| Aetna | 27486 | professional | 10 | 281.78 | 1154.16 | 2581.13 | 64.6% |
| Aetna | 29807 | professional | 10 | 200.74 | 778.21 | 1615.56 | 86.7% |
| Aetna | 62321 | professional | 10 | 47.01 | 207.99 | 1998.25 | 563.7% |
| Aetna | 63030 | professional | 10 | 185.79 | 728.72 | 2820.5 | 98.8% |
| Aetna | 63045 | professional | 10 | 234.57 | 840.35 | 1800.22 | 98.6% |
| Aetna | 63650 | professional | 10 | 172.34 | 423.48 | 2700 | 60.3% |
| Aetna | 63685 | professional | 10 | 70.27 | 326.45 | 1564 | 11.1% |
| Aetna | 64418 | professional | 10 | 24.42 | 67.75 | 1712.38 | 4308.6% |
| Aetna | 64450 | professional | 10 | 26.25 | 58.91 | 1612.25 | 4016.2% |
| Aetna | 64633 | professional | 10 | 111.21 | 308.93 | 1712.38 | 230.3% |
| Aetna | 64719 | professional | 10 | 81.6 | 338.91 | 1679.25 | 259.7% |
| Aetna | 10005 | professional | 9 | 20.05 | 68.96 | 2184 | 657.7% |
| Aetna | 10021 | professional | 9 | 18.56 | 61.87 | 1612.25 | 4028.2% |
| Aetna | 11640 | professional | 9 | 39.51 | 122.56 | 1794.5 | 2043.1% |
| Aetna | 11641 | professional | 9 | 40.83 | 144.47 | 1794.5 | 1831% |
| Aetna | 11642 | professional | 9 | 45.63 | 163.18 | 1794.5 | 1681.3% |
| Aetna | 11643 | professional | 9 | 49.58 | 191.86 | 1794.5 | 1516.2% |
| Aetna | 14041 | professional | 9 | 140.65 | 555.5 | 2098.75 | 270.3% |
| Aetna | 14060 | professional | 9 | 118.25 | 462.56 | 2098.75 | 270.3% |
| Aetna | 14061 | professional | 9 | 151.3 | 598.03 | 2098.75 | 270.3% |
| Aetna | 15823 | professional | 9 | 96.44 | 374.81 | 2497.75 | 304.7% |
| Aetna | 19296 | professional | 9 | 836.25 | 2765.5 | 4409.5 | 92.1% |
| Aetna | 19298 | professional | 9 | 273.46 | 1520.6 | 3677.5 | 62.8% |
| Aetna | 20553 | professional | 9 | 13.23 | 49.6 | 1812.5 | 7767.5% |
| Aetna | 21315 | professional | 9 | 46 | 162.08 | 1794.5 | 440.1% |
| Aetna | 21320 | professional | 9 | 47.78 | 172.49 | 1794.5 | 195.9% |
| Aetna | 21555 | professional | 9 | 72.89 | 286.45 | 1794.5 | 390.9% |
| Aetna | 22510 | professional | 9 | 292.01 | 1022.02 | 2700 | 199.2% |
| Aetna | 22511 | professional | 9 | 287.7 | 1006.93 | 2700 | 199.2% |
| Aetna | 22513 | professional | 9 | 880.16 | 2242.37 | 3300.58 | 93% |
| Aetna | 22800 | professional | 9 | 260.72 | 1013.42 | 2811.75 | 27% |
| Aetna | 22802 | professional | 9 | 411.17 | 1617.21 | 3052 | 26.1% |
| Aetna | 22804 | professional | 9 | 473.86 | 1865.51 | 3052 | 26.1% |
| Aetna | 22810 | professional | 9 | 399.29 | 1559.02 | 3046.6 | 26.1% |
| Aetna | 22812 | professional | 9 | 431.74 | 1690.34 | 3052 | 26.1% |
| Aetna | 22849 | professional | 9 | 253.94 | 1001.08 | 2811.75 | 39.5% |
| Aetna | 22850 | professional | 9 | 142.26 | 559.51 | 2811.75 | 98.6% |
| Aetna | 22852 | professional | 9 | 136.53 | 535.68 | 2811.75 | 98.6% |
| Aetna | 22855 | professional | 9 | 213.74 | 837.65 | 2811.75 | 98.6% |
| Aetna | 22856 | professional | 9 | 1444.04 | 2082.5 | 4410 | 33.5% |
| Aetna | 22861 | professional | 9 | 1948.95 | 2563 | 4143.95 | 31.2% |
| Aetna | 24500 | professional | 9 | 64.34 | 238.11 | 1612.25 | 1885.4% |
| Aetna | 24505 | professional | 9 | 89.16 | 331.84 | 1612.25 | 292.8% |
| Aetna | 25600 | professional | 9 | 60.49 | 221.92 | 1612.25 | 1885.4% |
| Aetna | 25605 | professional | 9 | 97.14 | 357.25 | 2098.75 | 349.5% |
| Aetna | 25607 | professional | 9 | 646.71 | 1928 | 3438.5 | 68.6% |
| Aetna | 25608 | professional | 9 | 724 | 1994 | 3438.5 | 68.4% |
| Aetna | 26600 | professional | 9 | 53.83 | 197.69 | 2314 | 3008% |
| Aetna | 27134 | professional | 9 | 379.99 | 1509.8 | 3229.68 | 47% |
| Aetna | 27278 | professional | 9 | 1306.36 | 3067.5 | 3866.45 | 23.8% |
| Aetna | 27279 | professional | 9 | 213.17 | 723.93 | 3067.5 | 23.7% |
| Aetna | 27280 | professional | 9 | 247.11 | 912.86 | 2811.75 | 26.4% |
| Aetna | 27750 | professional | 9 | 62.07 | 229.33 | 1612.25 | 1885.4% |
| Aetna | 27752 | professional | 9 | 95.57 | 354.13 | 1612.25 | 292.8% |
| Aetna | 27786 | professional | 9 | 56.13 | 207.98 | 1612.25 | 1885.4% |
| Aetna | 27808 | professional | 9 | 59.7 | 221.53 | 1612.25 | 1885.4% |
| Aetna | 27816 | professional | 9 | 58.3 | 217.49 | 1612.25 | 1885.4% |
| Aetna | 28470 | professional | 9 | 45.73 | 144.17 | 1612.25 | 1885.4% |
| Aetna | 29805 | professional | 9 | 86.66 | 318.17 | 1978 | 154.9% |
| Aetna | 29806 | professional | 9 | 205.7 | 798.35 | 2269.98 | 82.6% |
| Aetna | 29819 | professional | 9 | 120.72 | 490.9 | 1978 | 154.9% |
| Aetna | 29820 | professional | 9 | 111.88 | 459.71 | 2098.75 | 82.6% |
| Aetna | 29821 | professional | 9 | 121.96 | 495.35 | 1978 | 154.9% |
| Aetna | 29825 | professional | 9 | 120.63 | 490.38 | 1978 | 154.9% |
| Aetna | 29870 | professional | 9 | 95.12 | 371.57 | 1978 | 154.9% |
| Aetna | 29873 | professional | 9 | 102.65 | 393.66 | 1978 | 154.9% |
| Aetna | 29874 | professional | 9 | 108.58 | 435.76 | 1978 | 154.9% |
| Aetna | 29875 | professional | 9 | 100.32 | 402.7 | 2109.5 | 164.1% |
| Aetna | 29876 | professional | 9 | 129.12 | 508.33 | 2166 | 164.1% |
| Aetna | 29877 | professional | 9 | 121.41 | 473.05 | 2109.5 | 164.1% |
| Aetna | 29882 | professional | 9 | 135.6 | 530.26 | 1978 | 154.9% |
| Aetna | 29888 | professional | 9 | 196.01 | 781.28 | 2194.62 | 63.3% |
| Aetna | 29889 | professional | 9 | 237.03 | 918.08 | 2098.75 | 30.7% |
| Aetna | 29891 | professional | 9 | 132.66 | 520.22 | 1978 | 154.9% |
| Aetna | 29894 | professional | 9 | 104.03 | 427.08 | 1978 | 154.9% |
| Aetna | 29895 | professional | 9 | 99.37 | 412.64 | 1978 | 154.9% |
| Aetna | 29914 | professional | 9 | 893.5 | 1924 | 3594.5 | 92.2% |
| Aetna | 29915 | professional | 9 | 958.13 | 1924 | 3594.5 | 92.2% |
| Aetna | 29916 | professional | 9 | 910.42 | 1924 | 3594.5 | 92.2% |
| Aetna | 30115 | professional | 9 | 82.41 | 302.13 | 1794.5 | 195.9% |
| Aetna | 30130 | professional | 9 | 72.2 | 259.32 | 2098.75 | 206.1% |
| Aetna | 30140 | professional | 9 | 51.71 | 194.87 | 1794.5 | 195.9% |
| Aetna | 30420 | professional | 9 | 260.18 | 962.44 | 2530.75 | 113.6% |
| Aetna | 30450 | professional | 9 | 312.81 | 1145.67 | 2657.5 | 125.2% |
| Aetna | 30465 | professional | 9 | 186.62 | 700.36 | 2657.5 | 125.2% |
| Aetna | 30468 | professional | 9 | 313.05 | 1332.15 | 3400.75 | 90.5% |
| Aetna | 30469 | professional | 9 | 274.61 | 1169.14 | 3400.75 | 93.7% |
| Aetna | 30520 | professional | 9 | 116.29 | 416.1 | 2255.5 | 221.3% |
| Aetna | 30801 | professional | 9 | 42.65 | 118.34 | 1612.25 | 387.7% |
| Aetna | 30802 | professional | 9 | 48.41 | 170.12 | 1612.25 | 387.7% |
| Aetna | 30903 | professional | 9 | 40 | 146.05 | 1812.5 | 3475% |
| Aetna | 30905 | professional | 9 | 48 | 189.76 | 1812.5 | 3475% |
| Aetna | 30906 | professional | 9 | 48 | 219.65 | 1812.5 | 1973.4% |
| Aetna | 31231 | professional | 9 | 31.25 | 101.57 | 2025 | 2643.8% |
| Aetna | 31237 | professional | 9 | 44.9 | 168.38 | 2025 | 343.8% |
| Aetna | 31238 | professional | 9 | 44.07 | 165.26 | 2025 | 343.8% |
| Aetna | 31239 | professional | 9 | 117.04 | 461.14 | 2312 | 193.2% |
| Aetna | 31240 | professional | 9 | 38.1 | 124.28 | 2025 | 343.8% |
| Aetna | 31253 | professional | 9 | 113.31 | 452.87 | 3253 | 140.3% |
| Aetna | 31254 | professional | 9 | 61.57 | 254.38 | 2700 | 133.7% |
| Aetna | 31255 | professional | 9 | 59.32 | 292.59 | 3067.5 | 140.3% |
| Aetna | 31256 | professional | 9 | 40 | 149.89 | 2547.5 | 179.8% |
| Aetna | 31257 | professional | 9 | 100.96 | 403.67 | 3253 | 140.3% |
| Aetna | 31259 | professional | 9 | 106.92 | 427.37 | 3253 | 140.3% |
| Aetna | 31267 | professional | 9 | 48 | 236.65 | 2547.5 | 124.5% |
| Aetna | 31276 | professional | 9 | 73.14 | 341.79 | 2547.5 | 124.5% |
| Aetna | 31287 | professional | 9 | 46.31 | 173.65 | 1980 | 103.9% |
| Aetna | 31288 | professional | 9 | 48 | 202.47 | 1980 | 103.9% |
| Aetna | 31295 | professional | 9 | 1278.67 | 2547.5 | 3274.48 | 98.2% |
| Aetna | 31296 | professional | 9 | 1289.38 | 2547.5 | 3274.48 | 203.9% |
| Aetna | 31297 | professional | 9 | 1272.15 | 2547.5 | 3274.48 | 98% |
| Aetna | 31298 | professional | 9 | 396.8 | 1697.45 | 2988.5 | 133.7% |
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