Our provider cost estimator tool helps your office estimate how much your patients will owe for an office visit or procedure. And it approximates how much Aetna will pay for services. Plus, you can use it prior to a patient's scheduled appointment or procedure.
Patient cost estimator is available on our provider portal on Availity.
After entering basic patient and claims information, the cost estimator uses your fee schedule and your patients' benefits plans to:
This tool provides fee information for a sample scope of services that a doctor can provide. Contracted physicians can access fee schedules online on our secure provider website.* Fees displayed are based on contracted amounts negotiated for specified treatments. They reflect the amounts allowed for services as if Aetna is paying each ASNCPT/HCPCS code on a line-by-line, fee-for-service basis.
Note that physician fee schedule information will not display accurate rates for care services provided to Aetna members who participate in an accountable care organization {ACO) arrangement. A member with an ACO arrangement will have a member ID card with an ACO logo and/or network name. Providers should use the provider payment estimator tool to estimate costs for these patients.
Use our secure provider website to access electronic transactions and valuable resources to support your organization.
Find forms for claims, payment, billing. Medicare, pharmacy and more.
* Fee schedules are not available to an office classified as a hospital, ancillary or IPA/PHO; to an office with a billing set-up; or to behavioral health providers who are not MDs/DOs.
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna).
Health benefits and health insurance plans contain exclusions and limitations.
You are now being directed to the AMA site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to the Give an Hour site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to the CVS Pharmacy site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to the CDC site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy or privacy practices of linked sites, or for products or services described on these sites.
Aetna is proud to be part of the CVS Health family.
You are now being directed to the CVS Health site.
You are now being directed to the Apple.com COVID-19 Screening Tool
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to the US Department of Health and Human Services site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to the CVS Health COVID-19 testing site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
You are now being directed to
The Fight Is In Us site
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Links to various non-Aetna sites are provided for your convenience only. Aetna Inc. and its subsidiary companies are not responsible or liable for the content, accuracy, or privacy practices of linked sites, or for products or services described on these sites.
Please log in to your secure account to get what you need.
The information you will be accessing is provided by another organization or vendor. If you do not intend to leave our site, close this message.
Get a link to download the app
Just enter your mobile number and we’ll text you a link to download the Aetna Health app from the App Store or on Google Play.
Message and data rates may apply*
Each main plan type has more than one subtype. Some subtypes have five tiers of coverage. Others have four tiers, three tiers or two tiers. This search will use the five-tier subtype. It will show you whether a drug is covered or not covered, but the tier information may not be the same as it is for your specific plan. Do you want to continue?