Reasonable and customary (R&C)

The reasonable and customary fee is the average or commonly charged fee for the particular service within a geographic area or zip code. Aetna determines the R&C rates for all out-of-network services offered and considers the R&C charge only when calculating your portion of the cost. You pay all amounts over R&C charges. Also, charges in excess of the reasonable and customary charge do not count toward the deductible or out-of-pocket maximums. If you receive out-of-network care, reasonable and customary fees are an important consideration. R&C does not apply to in-network services.

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