Serif Health Aetna - Open Access Managed Choice (PPO)

Negotiated allowed amounts for the 293 most commonly billed medical codes (CPT, HCPCS, MS-DRG, and Revenue Codes) across in-network providers in the United States. Open Access Managed Choice is a national Aetna PPO network that underlies many of its commercial health plans. The dataset distinguishes professional from facility billing, captures site-of-care variation (e.g., hospital, ASC, office), and includes both inpatient and outpatient procedures. It spans a range of negotiation types (fee schedules, percentage of billed charges, per diem rates) and contracting arrangements (fee-for-service, bundled payments, and capitation).