What does aetna pay pain-management groups in CO?
Median published rate is 75.5% of Medicare across 125 NPIs (September 2026 files).
Data as of the September 2026 payer files.
Across 200 procedure codes and 1 payer, the median published rate is 138 percent of locality-adjusted Medicare in the September 2026 payer files. Aetna is the only payer with enough confirmed NPIs to publish here, at 138 percent of Medicare, so there is no spread to compare yet. The best-covered row rests on 125 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 | 125 | 17.9 | 86.83 | 118.59 | 75.5% |
| Aetna | 99213 | professional | 101 | 10.62 | 60.41 | 82.42 | 73% |
| Aetna | 99204 | professional | 92 | 23.03 | 119.75 | 183.29 | 79.8% |
| Aetna | 64483 | professional | 89 | 35.07 | 118.4 | 205.67 | 84.5% |
| Aetna | 64493 | professional | 83 | 132.37 | 157.91 | 211.14 | 88.6% |
| Aetna | 64635 | professional | 75 | 61.92 | 216.71 | 362.13 | 84.5% |
| Aetna | 27096 | professional | 74 | 24.87 | 62.18 | 147.03 | 86.4% |
| Aetna | 64494 | professional | 73 | 69.32 | 85.27 | 109.28 | 95.8% |
| Aetna | 64636 | professional | 68 | 29.03 | 108.87 | 161.06 | 66.3% |
| Aetna | 64490 | professional | 61 | 146.54 | 190.37 | 245.34 | 96.4% |
| Aetna | 64484 | professional | 60 | 15.75 | 56.63 | 93.29 | 86.4% |
| Aetna | 62323 | professional | 56 | 34.91 | 131.02 | 174.89 | 76.3% |
| Aetna | 62321 | professional | 50 | 36.17 | 135.64 | 202.32 | 81.3% |
| Aetna | 64491 | professional | 47 | 76.48 | 92.87 | 121.43 | 101.7% |
| Aetna | 20610 | professional | 43 | 10.36 | 27.5 | 55.85 | 105.3% |
| Aetna | 64633 | professional | 43 | 61.53 | 215.36 | 360.18 | 85.2% |
| Aetna | 99203 | professional | 42 | 13.05 | 74.35 | 105.57 | 76.6% |
| Aetna | 99215 | professional | 37 | 52.41 | 147.31 | 165.09 | 79% |
| Aetna | 20611 | professional | 36 | 15.78 | 59.18 | 95.17 | 91.1% |
| Aetna | 95886 | professional | 36 | 52.12 | 71.14 | 104.47 | 129.4% |
| Aetna | 64634 | professional | 32 | 27.42 | 88.69 | 169.41 | 62.4% |
| Aetna | 20553 | professional | 27 | 10 | 36.94 | 61.93 | 101% |
| Aetna | 76942 | professional | 22 | 37.64 | 47.15 | 80.25 | 127.7% |
| Aetna | 99205 | professional | 22 | 27.1 | 90.32 | 194.35 | 77.5% |
| Aetna | 20552 | professional | 21 | 8.85 | 41.94 | 69.85 | 131% |
| Aetna | 64479 | professional | 21 | 38.96 | 146.1 | 297.35 | 124.1% |
| Aetna | 77002 | professional | 21 | 51.29 | 96.66 | 154.64 | 126.2% |
| Aetna | 95909 | professional | 20 | 79.74 | 109.18 | 154.42 | 132.2% |
| Aetna | 95910 | professional | 15 | 101.52 | 140.12 | 192.34 | 128% |
| Aetna | 95911 | professional | 15 | 115.31 | 176.58 | 255.93 | 129.8% |
| Aetna | 64450 | professional | 14 | 11.14 | 38.03 | 57.51 | 99.1% |
| Aetna | 99212 | professional | 14 | 10.97 | 36.55 | 54.5 | 70.4% |
| Aetna | 63650 | professional | 12 | 195.44 | 651.46 | 1416.19 | 58.3% |
| Aetna | 72148 | professional | 12 | 126.63 | 240.08 | 499.75 | 183.3% |
| Aetna | 63685 | professional | 10 | 215.52 | 424.4 | 1509.74 | 71.3% |
| Aetna | 64616 | professional | 10 | 73.83 | 150.58 | 824.51 | 572.2% |
| Aetna | 72100 | professional | 10 | 17.13 | 34.6 | 48.94 | 131.7% |
| Aetna | 20550 | professional | 9 | 9.68 | 36.91 | 258.63 | 2409.9% |
| Aetna | 62370 | professional | 9 | 79.81 | 833.88 | 3161.95 | 1273.9% |
| Aetna | 72141 | professional | 9 | 126.54 | 233 | 466.36 | 183.9% |
| Aetna | 20604 | professional | 8 | 32.36 | 91.9 | 895.64 | 1550.2% |
| Aetna | 64418 | professional | 8 | 31.12 | 97.63 | 871.93 | 1673.4% |
| Aetna | 64640 | professional | 8 | 36.46 | 127.59 | 182.27 | 430.5% |
| Aetna | 64644 | professional | 8 | 27.32 | 104.31 | 644.48 | 713.8% |
| Aetna | 72110 | professional | 8 | 21.13 | 48.27 | 61.89 | 139% |
| Aetna | 95874 | professional | 8 | 26.71 | 78.46 | 87.48 | 123% |
| Aetna | 95908 | professional | 8 | 72.87 | 93.51 | 154.24 | 133.7% |
| Aetna | 20606 | professional | 7 | 30.12 | 85.73 | 1386.84 | 1551.2% |
| Aetna | 27278 | professional | 7 | 1234.16 | 3292.29 | 4119.93 | 25.7% |
| Aetna | 64615 | professional | 7 | 62.62 | 125.23 | 895.64 | 1170.3% |
| Aetna | 64624 | professional | 7 | 531.56 | 895.64 | 2860.45 | 94.4% |
| Aetna | 64625 | professional | 7 | 742.72 | 2513.81 | 3480.98 | 265% |
| Aetna | 64642 | professional | 7 | 50.55 | 148.62 | 1386.84 | 923.2% |
| Aetna | 20526 | professional | 6 | 824.51 | 1878.05 | 2860.45 | 3609.6% |
| Aetna | 20551 | professional | 6 | 824.51 | 1878.05 | 2860.45 | 5594.5% |
| Aetna | 62322 | professional | 6 | 824.51 | 1878.05 | 2860.45 | 406.8% |
| Aetna | 64447 | professional | 6 | 30.75 | 87.84 | 1957.75 | 2251.9% |
| Aetna | 64555 | professional | 6 | 38 | 116.71 | 895.64 | 45.4% |
| Aetna | 64646 | professional | 6 | 44.44 | 148.49 | 1878.05 | 1956.3% |
| Aetna | 72040 | professional | 6 | 17.13 | 30.07 | 48.35 | 132.6% |
| Aetna | 73030 | professional | 6 | 12.73 | 31.95 | 44.68 | 119.1% |
| Aetna | 97110 | professional | 6 | 29.59 | 32.37 | 36.3 | 98.5% |
| Aetna | 97112 | professional | 6 | 30.78 | 33.86 | 37.27 | 90.9% |
| Aetna | 10005 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 736.2% |
| Aetna | 10021 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 4508.9% |
| Aetna | 11640 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 2226.9% |
| Aetna | 11641 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 1995.7% |
| Aetna | 11642 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 1832.6% |
| Aetna | 11643 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 1652.6% |
| Aetna | 14040 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 280.2% |
| Aetna | 14041 | professional | 5 | 1960.77 | 3331 | 3353.95 | 295.2% |
| Aetna | 14060 | professional | 5 | 1960.77 | 3331 | 3353.95 | 295.2% |
| Aetna | 14061 | professional | 5 | 1960.77 | 3331 | 3353.95 | 295.2% |
| Aetna | 15823 | professional | 5 | 2756.81 | 3331 | 3866.45 | 295.2% |
| Aetna | 19296 | professional | 5 | 3331 | 4052.86 | 5055.53 | 90.7% |
| Aetna | 19298 | professional | 5 | 2715.54 | 3331 | 4143.95 | 57.4% |
| Aetna | 20600 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 8877.9% |
| Aetna | 20605 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 8785.2% |
| Aetna | 20680 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 268.7% |
| Aetna | 21315 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 479.7% |
| Aetna | 21320 | professional | 5 | 1576.27 | 3161.95 | 3161.95 | 213.6% |
| Aetna | 21555 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 426.1% |
| Aetna | 22510 | professional | 5 | 2513.81 | 4341.95 | 4341.95 | 264% |
| Aetna | 22511 | professional | 5 | 2513.81 | 4341.95 | 4341.95 | 264% |
| Aetna | 22513 | professional | 5 | 2756.81 | 4341.95 | 4341.95 | 117.5% |
| Aetna | 22514 | professional | 5 | 3816.53 | 4341.95 | 4341.95 | 117.5% |
| Aetna | 22551 | professional | 5 | 4496 | 4496 | 7454.33 | 49.8% |
| Aetna | 22558 | professional | 5 | 4496 | 4496 | 9569.5 | 22.4% |
| Aetna | 22600 | professional | 5 | 4496 | 4496 | 5440 | 34.3% |
| Aetna | 22612 | professional | 5 | 4496 | 4496 | 7454.33 | 33.3% |
| Aetna | 22630 | professional | 5 | 4496 | 4496 | 5440 | 21.6% |
| Aetna | 22633 | professional | 5 | 4496 | 4496 | 9569.5 | 21.6% |
| Aetna | 22800 | professional | 5 | 2715.54 | 4143.95 | 4143.95 | 30.7% |
| Aetna | 22802 | professional | 5 | 2715.54 | 4143.95 | 4143.95 | 29.7% |
| Aetna | 22804 | professional | 5 | 2715.54 | 4143.95 | 4143.95 | 29.7% |
| Aetna | 22810 | professional | 5 | 2715.54 | 4143.95 | 4143.95 | 29.7% |
| Aetna | 22812 | professional | 5 | 2715.54 | 4143.95 | 4143.95 | 29.7% |
| Aetna | 22849 | professional | 5 | 2715.54 | 4143.95 | 4143.95 | 45% |
| Aetna | 22850 | professional | 5 | 4496 | 4496 | 5440 | 121.7% |
| Aetna | 22852 | professional | 5 | 4143.95 | 4143.95 | 5440 | 112.1% |
| Aetna | 22855 | professional | 5 | 4143.95 | 4143.95 | 5440 | 112.1% |
| Aetna | 22856 | professional | 5 | 4496 | 4496 | 5891.34 | 34.3% |
| Aetna | 22861 | professional | 5 | 4143.95 | 4143.95 | 5440 | 35.4% |
| Aetna | 23472 | professional | 5 | 4341.95 | 4341.95 | 11935.5 | 31.2% |
| Aetna | 24500 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2110.4% |
| Aetna | 24505 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 327.7% |
| Aetna | 25600 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2110.4% |
| Aetna | 25605 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 384.2% |
| Aetna | 25607 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 77.8% |
| Aetna | 25608 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 77.6% |
| Aetna | 25609 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 77.1% |
| Aetna | 26055 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 362.2% |
| Aetna | 26160 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 384.2% |
| Aetna | 27130 | professional | 5 | 4143.95 | 4143.95 | 11935.5 | 43.1% |
| Aetna | 27134 | professional | 5 | 2715.54 | 4496 | 4496 | 48.2% |
| Aetna | 27236 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 79.2% |
| Aetna | 27245 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 80% |
| Aetna | 27279 | professional | 5 | 2756.81 | 4341.95 | 4341.95 | 29.9% |
| Aetna | 27280 | professional | 5 | 2715.54 | 4382.5 | 4496 | 31.7% |
| Aetna | 27446 | professional | 5 | 4341.95 | 4341.95 | 8491.06 | 47.1% |
| Aetna | 27447 | professional | 5 | 4143.95 | 4143.95 | 11927.04 | 44.1% |
| Aetna | 27486 | professional | 5 | 2715.54 | 4496 | 4496 | 66.1% |
| Aetna | 27487 | professional | 5 | 2715.54 | 4496 | 4496 | 32.2% |
| Aetna | 27750 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2110.4% |
| Aetna | 27752 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 327.7% |
| Aetna | 27786 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2110.4% |
| Aetna | 27808 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2110.4% |
| Aetna | 27816 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2110.4% |
| Aetna | 28470 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2110.4% |
| Aetna | 29805 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29806 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 90.8% |
| Aetna | 29807 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 90.8% |
| Aetna | 29819 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29820 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 90.8% |
| Aetna | 29821 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29822 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29823 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29824 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 235.1% |
| Aetna | 29825 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29827 | professional | 5 | 3743.91 | 3866.45 | 3866.45 | 104.6% |
| Aetna | 29828 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 90.8% |
| Aetna | 29870 | professional | 5 | 2555.39 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29873 | professional | 5 | 2555.39 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29874 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29875 | professional | 5 | 2831.91 | 3630.95 | 3630.95 | 220.7% |
| Aetna | 29876 | professional | 5 | 2831.91 | 3630.95 | 3630.95 | 220.7% |
| Aetna | 29877 | professional | 5 | 2831.91 | 3630.95 | 3630.95 | 220.7% |
| Aetna | 29879 | professional | 5 | 2555.39 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29880 | professional | 5 | 2831.91 | 3630.95 | 3630.95 | 220.7% |
| Aetna | 29881 | professional | 5 | 2831.91 | 3630.95 | 3630.95 | 220.7% |
| Aetna | 29882 | professional | 5 | 2555.39 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29888 | professional | 5 | 3353.95 | 3353.95 | 4009.79 | 69.6% |
| Aetna | 29889 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 33.8% |
| Aetna | 29891 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29894 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29895 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 203.9% |
| Aetna | 29914 | professional | 5 | 2513.81 | 3630.95 | 3630.95 | 98.3% |
| Aetna | 29915 | professional | 5 | 2513.81 | 3630.95 | 3630.95 | 98.3% |
| Aetna | 29916 | professional | 5 | 2513.81 | 3630.95 | 3630.95 | 98.3% |
| Aetna | 30115 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 213.6% |
| Aetna | 30130 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 226.5% |
| Aetna | 30140 | professional | 5 | 1552.42 | 3161.95 | 3161.95 | 213.6% |
| Aetna | 30420 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 127.8% |
| Aetna | 30450 | professional | 5 | 2881.8 | 4041.5 | 4367.45 | 133.6% |
| Aetna | 30465 | professional | 5 | 2881.8 | 4041.5 | 4367.45 | 133.6% |
| Aetna | 30468 | professional | 5 | 2881.8 | 4041.5 | 4367.45 | 96.5% |
| Aetna | 30469 | professional | 5 | 2881.8 | 4041.5 | 4367.45 | 100% |
| Aetna | 30520 | professional | 5 | 2513.81 | 3630.95 | 3630.95 | 245.3% |
| Aetna | 30801 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 433.9% |
| Aetna | 30802 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 433.9% |
| Aetna | 30903 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 3889.7% |
| Aetna | 30905 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 3889.7% |
| Aetna | 30906 | professional | 5 | 895.64 | 2860.45 | 2860.45 | 2208.8% |
| Aetna | 31231 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 2881.6% |
| Aetna | 31237 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 374.7% |
| Aetna | 31238 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 374.7% |
| Aetna | 31239 | professional | 5 | 2513.81 | 3630.95 | 3630.95 | 214% |
| Aetna | 31240 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 374.7% |
| Aetna | 31253 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 157.7% |
| Aetna | 31254 | professional | 5 | 2890.65 | 3630.95 | 3630.95 | 148.1% |
| Aetna | 31255 | professional | 5 | 2756.81 | 3866.45 | 3866.45 | 157.7% |
| Aetna | 31256 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 197.7% |
| Aetna | 31257 | professional | 5 | 3180.41 | 3866.45 | 3866.45 | 157.7% |
| Aetna | 31259 | professional | 5 | 3180.41 | 3866.45 | 3866.45 | 157.7% |
| Aetna | 31267 | professional | 5 | 2564.79 | 3353.95 | 3353.95 | 136.8% |
| Aetna | 31276 | professional | 5 | 2614.13 | 3353.95 | 3353.95 | 136.8% |
| Aetna | 31287 | professional | 5 | 2614.13 | 3353.95 | 3353.95 | 136.8% |
| Aetna | 31288 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 136.8% |
| Aetna | 31295 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 108% |
| Aetna | 31296 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 224.1% |
| Aetna | 31297 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 107.7% |
| Aetna | 31298 | professional | 5 | 2513.81 | 3630.95 | 3630.95 | 148.1% |
| Aetna | 31535 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 186.4% |
| Aetna | 31536 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 197.7% |
| Aetna | 31540 | professional | 5 | 1960.77 | 3353.95 | 3353.95 | 197.7% |
| Aetna | 31541 | professional | 5 | 2513.81 | 3630.95 | 3630.95 | 214% |
| Aetna | 31575 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 3412.8% |
| Aetna | 31576 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 374.7% |
| Aetna | 31577 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 1471.9% |
| Aetna | 31578 | professional | 5 | 1192.31 | 3161.95 | 3161.95 | 186.4% |
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