🏥 Aetna Negotiated Rates

Aetna Negotiated Rates
via REST API

PPO, HMO, Open Choice. 380M+ rate rows. Query Aetna rates by CPT code, NPI, or billing code. No ETL. No 200 GB JSON files.

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380M+
Rate Rows Indexed
750K+
Providers
12,000+
Billing Codes
Monthly
Refresh Cycle
Network Coverage

All Aetna Networks, Unified

Aetna — now part of CVS Health — publishes MRF data across its commercial PPO, HMO, Open Choice, and Signature networks alongside full OON allowed-amount files. PayerBenchmark normalizes and indexes all Aetna MRFs monthly.

Aetna PPO Aetna HMO Open Choice PPO Signature Network Aetna OON
REST API

Query Aetna Rates in One Request

Filter by CPT code, NPI, network, and date range. Paginated JSON — no parsing multi-gigabyte files.

●●● GET /v1/rates 
GET https://api.payerbenchmark.com/v1/rates
  ?payer=Aetna
  &procedure_code=99213
  &npi=1234567890

// Response
{
  "data": [{
    "payer":          "Aetna",
    "network_key":    "Aetna PPO",
    "procedure_code": "99213",
    "negotiated_rate": 87.42,
    "rate_type":      "fee_for_service",
    "effective_date": "2025-01-01"
  }],
  "meta": { "total": 14, "page": 1, "per_page": 50 }
}
GET /v1/rates Negotiated rates for Aetna filtered by CPT, NPI, and network.
GET /v1/benchmarks Cross-payer p10–p90 percentiles. See where Aetna rates rank vs. market.
GET /v1/oon/rates Aetna out-of-network allowed amounts by NPI and procedure code.
FAQ

Aetna Rate Data — Common Questions

Which Aetna networks are included?

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PayerBenchmark covers Aetna PPO, Aetna HMO, Open Choice PPO, Signature Network, and Aetna's OON allowed-amount files — all networks published in Aetna's CMS MRF disclosures.

Can I filter Aetna rates by plan type?

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Yes. Each rate row includes a network_key field (e.g. AETNA|PPO, AETNA|HMO) that identifies the specific plan network. You can filter by network_key to isolate commercial PPO vs. HMO rates.

How do Aetna rates compare to other payers?

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The /v1/benchmarks endpoint returns p10–p90 percentiles computed across all payers including Aetna. You can see exactly where Aetna's rates fall relative to Cigna, UHC, and BCBS for any CPT code.

Is Aetna out-of-network data available?

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Yes. Aetna OON allowed-amount files are indexed and queryable via /v1/oon/rates, filterable by NPI, procedure code, and date range.

Start Querying Aetna Rates Today

API access to 380M+ rate rows across all Aetna networks. No ETL pipeline required.

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