Save on Health Care Costs with Aetna's Price Estimator

Tuesday, December 1, 2015

DES MOINES, Iowa — Aetna is improving health care transparency and helping people in Iowa and Nebraska save money by launching its award-winning Member Payment Estimator. The Member Payment Estimator provides a more complete, personalized picture of the costs involved with health care.

Available online or through Aetna's mobile app, the Member Payment Estimator provides real-time out-of-pocket cost estimates and cost comparisons for more than 650 commonly used, non-emergency in-network health services including traditional or C-section births, colonoscopies, MRIs and CT scans. The tool for Aetna members displays up to 10 cost estimates at a time for a selected procedure in a geographic area, which can help make members more aware of the cost differences among different health care providers.

Aetna's estimates are derived from actual claims for a procedure and provider, and then calculated to include information based on the member's actual benefit plan, such as their deductible, copayments and Aetna's negotiated rates. The tool also includes data on out-of-network providers.

According to Kaiser Family Foundation's 2012 Health Tracking Poll, about 58 percent of households put off care because of costs. Aetna's tool gives members an idea of costs ahead of time helping to eliminate surprise bills or bills that are higher than expected. For example, a quick search for a complete shoulder x-ray on the Member Payment Estimator reveals costs of $552.48 at Provider A, $210.85 at Provider B and $46.85 at Provider C in Des Moines. In Omaha the same complete shoulder x-ray costs $297.63 at Provider A, $404.37 at Provider B and $38.63 at Provider C.

"Unlike a television or car, the cost of a given health care procedure can vary widely between health facilities or doctors and from one region to another," Dale Mackel, president of Aetna's Iowa and Nebraska operations, explained. "In our experience, Aetna members saved an average of $170 in out-of-pocket costs for 34 common procedures by using the payment estimator."

In 2014 members accessed the Member Payment Estimator 1,603,311 times, an average of 133,609 hits per month. This was a 23 percent increase in hits from the previous year. There have been more than 6.3 million hits since current form of the tool was launched in 2010. The roll-out to Iowa and Nebraska is a reflection of Aetna's growing presence in those states and the continuing integration of Aetna's capabilities with Coventry products.

When Aetna launched its price transparency effort in 2005, it was the first national health insurer to provide members with the actual, negotiated rates the company pays to participating network physicians for common services and procedures.

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving an estimated 46.5 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services, workers’ compensation administrative services and health information technology products and services. Aetna’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see

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Rohan Hutchings
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