Median Percent of Medicare, Exchange Networks by Payer and Billing Class (January 2025)
January 2025 Transparency in Coverage (TiC) data sourced and enriched by Serif Health. Posted negotiated rates were compared to 2025 Medicare benchmarks derived from the national IPPS, OPPS, and ASC fee schedules for providers eligible to bill the code. Standard Serif quality filters were applied, excluding percentage-of-charge and per diem rates. Outliers below 50% or above 1000% of Medicare were dropped. Medians estimated within state averaged for national estimates. Across the16 states where Aetna operated an Exchange plan, UnitedHealthcare operated in 10 states and Cigna in 7.