Aetna employer health plans in New York
Who Aetna insures among New York employers and what those plans pay in premium and broker compensation, and what the Aetna network pays physicians and hospitals.
Aetna employer health plans in New York at a glance
What the data shows
Aetna insures 348 employer health plans in New York (13% of 2,760 insured large plans), 5th of 8 carrier groups; Cigna (799), Blue Cross Blue Shield (603) hold more.
Aetna has grown 12% in New York since 2020, from 311 plans.
Most of these plans cover 100–499 people (201 plans); 34 cover 1,000 or more.
Median premium per person covered was $8,436, 7% below the New York all-carrier median of $9,072. Benefit design and group mix differ, so this is not a price comparison.
79% of these plans reported broker or agent pay on their Aetna contracts; where paid, the median was 4.2% of premium (middle half 3.0%–5.5%).
In Aetna commercial, 28 of the 50 Employer 50 services have a New York benchmark, at a median of 103% of Medicare across those services.
At New York hospitals, Aetna's commercial rates run higher than other carriers' at the same hospital for 9 of 17 services; a hip or knee replacement stay has a median rate of $25,847 across 36 hospitals.
Aetna plans in New York, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 311 | 331,862 | 11% | $6,926 |
| 2021 | 302 | 367,922 | 11% | $6,692 |
| 2022 | 324 | 391,989 | 12% | $7,168 |
| 2023 | 333 | 404,862 | 12% | $8,004 |
| 2024 | 348 | 386,373 | 13% | $8,436 |
| 2025 (partial) | 244 | 202,239 | 12% | $8,719 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 53 | 15% |
| 100–499 | 201 | 58% |
| 500–999 | 58 | 17% |
| 1,000–4,999 | 30 | 9% |
| 5,000 or more | 4 | 1% |
Premiums and broker pay
| Measure | Aetna | All carriers, New York |
|---|---|---|
| Median premium per person covered | $8,436 | $9,072 |
| Premium per person, middle half | $5,015–$10,710 | $5,677–$12,803 |
| Plans reporting broker or agent pay | 79% | 79% |
| Median broker pay, % of premium | 4.2% | 4.1% |
| Broker pay, middle half | 3.0%–5.5% | 3.0%–5.4% |
| Median broker pay per person covered | $306 | $371 |
Industries
Aetna's New York employer clients are concentrated in professional and technical services (50 plans) and health care and social assistance (46), followed by finance and insurance (40).
| Industry | Plans | Share |
|---|---|---|
| Professional and technical services | 50 | 14% |
| Health care and social assistance | 46 | 13% |
| Finance and insurance | 40 | 11% |
| Educational services | 34 | 10% |
| Wholesale trade | 26 | 7% |
| Manufacturing | 24 | 7% |
Aetna employer clients in New York
313 employers in New York have a Aetna major-medical contract, 34 of them covering 1,000 or more people. For each one Medlyze has the plan year, the broker on each contract and what that broker was paid, and compiles the list for a state, an industry or a single employer on request.
| Employer | Persons covered | Plan year ends | Broker | Broker pay, % of premium |
|---|---|---|---|---|
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
What the Aetna network pays physicians in New York
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $328 | $288–$369 | 114% | $424 | 102 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $232 | $201–$267 | 118% | $296 | 115 |
| Electrocardiogram (EKG), complete | 93000 | $17 | $15–$21 | 109% | $22 | 114 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $431 | $320–$516 | 101% | $584 | 108 |
| Treadmill stress test, complete | 93015 | $79 | $67–$100 | 108% | $110 | 96 |
| Cataract removal with lens implant | 66984 | $758 | $683–$758 | 164% | $595 | 105 |
| Abdominal ultrasound, complete | 76700 | $39 | $32–$46 | 105% | $55 | 157 |
| Bone density scan (DXA), axial | 77080 | $42 | $37–$72 | 106% | $67 | 154 |
| CT abdomen and pelvis with contrast | 74177 | $391 | $321–$466 | 130% | $496 | 152 |
| CT chest without contrast | 71250 | $172 | $167–$223 | 129% | $269 | 154 |
| Chest X-ray, 2 views | 71046 | $34 | $27–$39 | 103% | $43 | 159 |
| MRI brain without and with contrast | 70553 | $408 | $375–$600 | 129% | $667 | 160 |
| MRI cervical spine without contrast | 72141 | $375 | $370–$464 | 197% | $396 | 159 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $375 | $370–$475 | 183% | $418 | 162 |
| MRI lumbar spine without contrast | 72148 | $375 | $370–$464 | 196% | $395 | 160 |
Professional fee only: facility, implant and anesthesia charges are not included. Limited: rates come from a sample of providers, and groups are counted only in specialties that perform the service.
What the Aetna network pays hospitals in New York
Aetna commercial rates are on record at 54 New York hospitals (the hospitals covered so far, not every hospital). Compared at the same hospitals, Aetna's rate is higher than the other carriers' median for 9 of 17 services and lower for 5. For Emergency visit, level 4, the rate runs from $132 to $2,625 across 25 hospitals.
This page shows 3 of the 17 services in full. The other rates, the size of each gap and every hospital's prices are in the Plan Cost Benchmark.
| Service | Hospitals | Median rate | Range (P10–P90) | vs other carriers, same hospitals | Cash price, median |
|---|---|---|---|---|---|
| Hip or knee replacement (hospital stay) | 36 | $25,847 | $11,477–$54,334 | Lower | $21,424 |
| C-section delivery (hospital stay) | 35 | Locked | Locked | About the same | Locked |
| Vaginal delivery (hospital stay) | 32 | Locked | Locked | Lower | Locked |
| MRI, lower back | 29 | $658 | $147–$2,876 | Higher | $1,622 |
| MRI, knee | 30 | Locked | Locked | Higher | Locked |
| CT, head | 31 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 32 | Locked | Locked | Higher | Locked |
| Screening mammogram | 30 | Locked | Locked | Higher | Locked |
| Colonoscopy, diagnostic | 27 | Locked | Locked | Lower | Locked |
| Upper GI endoscopy with biopsy | 27 | Locked | Locked | Lower | Locked |
| Knee arthroscopy | 26 | Locked | Locked | Higher | Locked |
| Cataract surgery | 23 | Locked | Locked | Higher | Locked |
| Gallbladder removal, laparoscopic | 28 | Locked | Locked | Lower | Locked |
| Knee replacement, outpatient | 20 | Locked | Locked | Higher | Locked |
| Emergency visit, level 4 | 25 | $1,687 | $132–$2,625 | About the same | $499 |
| Comprehensive metabolic panel | 28 | Locked | Locked | Higher | Locked |
| Complete blood count | 29 | Locked | Locked | About the same | Locked |
Hospitals with the most published Aetna rates
| Hospital | Joint replacement | MRI lower back | CT abdomen | Colonoscopy | ER level 4 | Vaginal delivery |
|---|---|---|---|---|---|---|
| Catholic Health St. Catherine Of Siena Hospital | $32,525 | Locked | Locked | Locked | Locked | Locked |
| Catholic Health St. Charles Hospital | $32,985 | Locked | Locked | Locked | Locked | Locked |
| Catholic Health St. Francis Hospital & Heart Center | $49,587 | Locked | Locked | Locked | Locked | Locked |
| Catholic Health St. Joseph Hospital | $32,321 | Locked | Locked | Locked | Locked | Locked |
| Garnet Health Medical Center | $57,867 | Locked | Locked | Locked | Locked | Locked |
| Garnet Health Medical Center - Catskills, Harris Campus | $49,579 | Locked | Locked | Locked | Locked | Locked |
| Montefiore Mount Vernon Hospital | $54,334 | Locked | Locked | Locked | Locked | Locked |
| Nassau University Medical Center | $22,877 | Locked | Locked | Locked | Locked | Locked |
| St. James Hospital | $10,096 | Locked | Locked | Locked | Locked | Locked |
| Uhs Binghamton General Hospital | $39,253 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 24%, fee schedules 53%, per diem 1%, percent of billed charges 15%, other 7% of Aetna's published commercial rates for these services in New York.
Employers: see all 17 services and every hospital near your people in a Plan Cost Benchmark →
Hospital facility rate only: physician, anesthesia and implant charges are separate. Rates are what hospitals publish, not claims paid, and are not weighted by use.
Carriers in New York
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Cigna | 799 | 29% | $8,959 | 5.4% |
| Blue Cross Blue Shield | 603 | 22% | $10,634 | 3.7% |
| UnitedHealthcare | 532 | 19% | $9,011 | 4.3% |
| Other insurers (regional and local plans) | 530 | 19% | $8,835 | 3.8% |
| Aetna | 348 | 13% | $8,436 | 4.2% |
| Anthem (Elevance Health) | 270 | 10% | $8,845 | 4.0% |
| Kaiser Permanente | 244 | 9% | $9,169 | 4.2% |
| Humana | 10 | 0% | $3,012 | 3.5% |
Aetna in other states
FAQ
How many New York employers have Aetna health insurance?
348 employer health plans in New York reported a Aetna major-medical contract in their 2024 filings, covering 386,373 persons. Self-funded plans that Aetna only administers are not counted.
What is Aetna's share of the New York insured employer market?
13% of insured large employer health plans, 5th of 8 carrier groups by plan count.
How much do brokers earn on Aetna plans in New York?
Where broker or agent pay was reported, the median was 4.2% of premium (4.1% across all carriers in New York).
Can I see the figures for a specific employer?
Yes. Brokers can request an Employer Account Brief on one employer, or a Prospect List for this market. Employers can request a Plan Cost Benchmark for their own plan. Use the request form on this page.
About these numbers
- Plans counted: the 348 New York employer health plans with a Aetna major-medical contract in their 2024 filings. Self-funded plans that Aetna only administers are not counted here.
- Premium and broker figures: 320 contracts with 20+ persons covered and a reported premium; broker percentages use the 273 contracts that reported broker or agent pay.
- Network rates: Aetna commercial, professional fees only, from a sample of providers.
- Hospital prices: Aetna commercial rates at New York hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.