D2740 Crown Reimbursement Gap: Aetna at $255, Delta at $727, and the $472 Your Practice Is Leaving Behind

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D2740 is the CDT code for an all-ceramic or porcelain crown — one of the highest-volume restorative procedures in general dentistry. Aetna's average negotiated rate for D2740 is $255 across 1,189 provider-rate data points. Delta Dental of Michigan's average is $727 across 311 data points. The gap between those two numbers — $472 per crown — represents money that flows to a practice with Delta Dental patients and disappears from a practice with the same clinical output but an Aetna-dominant payer mix. At 100 crowns annually, that single carrier differential is worth $47,200 per year. This article gives you the complete D2740 picture and a specific negotiation strategy for closing the gap.

D2740 Rate Data: The Full Picture

The D2740 negotiated rate data is the most complete dataset available for any single dental CDT code. Here is the complete picture from verified carrier and state sources:

By Carrier

• Aetna: average $255, range $54–$2,115 (n=1,189). The range width — from $54 to $2,115 on the same code, same carrier — reflects contract age variation, geographic tier differences, and network leasing repricing. The median is likely lower than $255.
• Delta Dental of Michigan: average $727, range $52–$1,867 (n=311). Delta Dental's higher average reflects both market positioning and a historically stronger provider network position in the Midwest.
• D2750 (porcelain fused to high noble metal, for comparison): Aetna average $487, range $10–$1,659. This code runs higher than D2740 under Aetna but the floor — $10 — represents one of the most extreme legacy-contract situations documented in the public rate data.

D2740 by State

• New York: $982
• Washington: $957
• Florida: $879
• California: $834
• Texas: $790
• New Mexico: $757
• Missouri: $739
• North Carolina: $691
• New Jersey: $684
• Wyoming: $90

The state-level data shows that the Aetna national average of $255 is below every listed state average except Wyoming. That means a practice in any of the listed states that is contracted with Aetna at the $255 national average level is below-market in their specific geography — regardless of Aetna's overall network positioning.

UnitedHealthcare's D2740 Rate Structure

UHC does not publish a single national D2740 average in the same format as Aetna. UHC's dental product operates through multiple tiers: the direct UHC Dental PPO for large employer groups, and access through Dental Benefit Providers (DBP) for smaller groups and ASO arrangements. UHC's rates for D2740 in high-rate states tend to be competitive with mid-tier regional carriers — generally in the $600 to $900 range in Florida, California, and New York. But the UHC rate a specific practice collects depends on which UHC product the patient's employer selected, not just whether the patient has a UHC card.

This product-level variation inside UHC is the mirror image of the Aetna PPO vs. Dental Access split. A UHC patient from a large employer plan (high-tier) may generate a D2740 payment near market average. A UHC patient from a small employer ASO plan (low-tier, possibly routed through DBP) may generate a payment closer to the Aetna national average — or below. Your EOB repricing entity field tells you which product processed each claim. If you see "Dental Benefit Providers" or "DBP" on a UHC patient's EOB, that is a different rate tier than UHC Direct.

The Aetna Rate Problem: Why $255 Is a Legacy Artifact, Not a Market Rate

The Aetna national average of $255 for D2740 is not a fair market value determination — it is an average of an enormously dispersed set of individually negotiated contracts, many of which were signed decades ago and have never been renegotiated. The range from $54 to $2,115 proves this: providers collecting $2,115 for a D2740 under Aetna are in the same network as providers collecting $54. The difference between those two outcomes is almost entirely explained by when the contract was signed, whether it has been renegotiated, and whether the practice has volume leverage.

For practices currently contracted with Aetna at or below the $255 average, the practical question is not whether renegotiation is possible — it is whether the practice has done the preparation necessary to make the ask effectively. That preparation requires knowing your current contracted rate precisely, knowing your state's market average, knowing your annual D2740 volume, and calculating the dollar amount at stake. All four of those numbers should be in hand before you call provider relations.

Step-by-Step: Auditing and Acting on Your D2740 Rate

1. Get your current D2740 contracted rate in writing from every carrier. Call or email provider relations for Aetna, Delta Dental, and any other carrier where D2740 is in your top 10 codes by volume. Request the fee schedule for your specific NPI. Note the date of the fee schedule as well — a fee schedule from 2019 may not reflect current contracted terms.
2. Pull your D2740 claim count for the past 12 months. Your practice management system can produce this report filtered by CDT code. You need total claim count and total allowed amounts paid for D2740 by each carrier.
3. Calculate your effective rate per carrier. Divide total D2740 allowed amounts paid by the number of D2740 claims for each carrier. Compare this effective rate against your contracted rate. If effective rate is below contracted rate, you have a repricing issue. If effective rate matches contracted rate but both are below the state average, you have a negotiation issue.
4. Identify your state average from the data table above. Calculate the gap between your current contracted rate and the state average. Multiply by your annual D2740 claim count. That product is your annual dollar case for renegotiation.
5. Call Aetna provider relations and open a fee schedule review. Most carrier provider relations lines have a formal process for fee schedule amendment requests. Ask to be connected to a provider contract specialist (not the general member services line). State your request specifically: "I am requesting a fee schedule review for D2740. My current contracted rate is [X]. The state average for my geography is [Y]. I am requesting an amendment to [Z]."

Annual Financial Impact: The Full Math

For a practice with 100 annual D2740 claims split across Aetna (40%), Delta Dental (30%), and other carriers (30%):

• Aetna: 40 crowns × $255 = $10,200
• Delta Dental: 30 crowns × $727 = $21,810
• Other carriers at $600 average: 30 crowns × $600 = $18,000
• Total annual D2740 revenue: $50,010

If Aetna rates were renegotiated to $600 (still below state average for most markets):

• Aetna: 40 crowns × $600 = $24,000
• Delta Dental: 30 crowns × $727 = $21,810
• Other carriers: 30 crowns × $600 = $18,000
• Total annual D2740 revenue: $63,810
• Annual improvement from Aetna renegotiation alone: $13,800

That $13,800 figure is conservative — it uses a target rate well below the state averages for high-rate states. In Florida, Texas, or California, a successful renegotiation targeting the state average would produce a much larger improvement.

What to Do This Week

1. Request D2740 and D2750 fee schedules from Aetna and your other top carriers today. Use email so you have a written record. Address it to provider relations. Give them your NPI and request a fee schedule effective as of today.
2. Pull your 12-month D2740 and D2750 claim summary. Total claims by carrier, total allowed amounts by carrier, average allowed by carrier. Build this into a simple spreadsheet.
3. Compare your effective rate against state averages from the table in this article. If you are in a state listed above and your Aetna rate is below $400, you are well below the state average for any listed geography and have strong grounds for a formal rate increase request.
4. Check EOBs for D2740 repricing entity names. Any crown claim processed through a leased network at a rate below your Aetna PPO contracted rate is a compliance issue you should raise with Aetna provider relations separately from the base rate negotiation.
5. Quantify the gap and write the negotiation number down before you make the call. Providers who walk into fee negotiations with specific dollar amounts — "I am requesting an increase from $255 to $600, which would increase my annual revenue from Aetna by approximately $14,000" — are more successful than those who ask generally for better rates.