Aetna employer health plans in Ohio
Who Aetna insures among Ohio 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 Ohio at a glance
What the data shows
Aetna insures 108 employer health plans in Ohio (8% of 1,408 insured large plans), 5th of 8 carrier groups; Anthem (Elevance Health) (395), UnitedHealthcare (254) hold more.
Aetna has grown 6% in Ohio since 2020, from 102 plans.
Most of these plans cover 100–499 people (73 plans); 8 cover 1,000 or more.
Median premium per person covered was $5,877, 11% below the Ohio all-carrier median of $6,598. Benefit design and group mix differ, so this is not a price comparison.
69% of these plans reported broker or agent pay on their Aetna contracts; where paid, the median was 1.4% of premium (middle half 0.5%–3.8%).
In Aetna commercial, 28 of the 50 Employer 50 services have a Ohio benchmark, at a median of 128% of Medicare across those services.
At Ohio hospitals, Aetna's commercial rates run higher than other carriers' at the same hospital for 13 of 17 services; a hip or knee replacement stay has a median rate of $26,563 across 22 hospitals.
Aetna plans in Ohio, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 102 | 55,907 | 6% | $4,684 |
| 2021 | 111 | 55,926 | 8% | $4,674 |
| 2022 | 111 | 68,037 | 8% | $5,182 |
| 2023 | 136 | 204,835 | 9% | $5,617 |
| 2024 | 108 | 54,917 | 8% | $5,877 |
| 2025 (partial) | 59 | 30,064 | 6% | $6,013 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 12 | 11% |
| 100–499 | 73 | 68% |
| 500–999 | 15 | 14% |
| 1,000–4,999 | 7 | 6% |
| 5,000 or more | 1 | 1% |
Premiums and broker pay
| Measure | Aetna | All carriers, Ohio |
|---|---|---|
| Median premium per person covered | $5,877 | $6,598 |
| Premium per person, middle half | $4,261–$7,169 | $3,981–$10,071 |
| Plans reporting broker or agent pay | 69% | 80% |
| Median broker pay, % of premium | 1.4% | 3.6% |
| Broker pay, middle half | 0.5%–3.8% | 2.4%–5.2% |
| Median broker pay per person covered | $67 | $233 |
Industries
Aetna's Ohio employer clients are concentrated in manufacturing (33 plans) and health care and social assistance (11), followed by professional and technical services (10).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 33 | 31% |
| Health care and social assistance | 11 | 10% |
| Professional and technical services | 10 | 9% |
| Retail trade | 9 | 8% |
| Finance and insurance | 7 | 6% |
| Accommodation and food services | 7 | 6% |
Aetna employer clients in Ohio
104 employers in Ohio have a Aetna major-medical contract, 8 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 Ohio
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $359 | $310–$447 | 125% | $434 | 51 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $81 | $72–$104 | 121% | $100 | 54 |
| Electrocardiogram (EKG), complete | 93000 | $17 | $15–$22 | 111% | $21 | 55 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $82 | $73–$105 | 110% | $98 | 54 |
| Treadmill stress test, complete | 93015 | $78 | $75–$94 | 106% | $104 | 33 |
| Cataract removal with lens implant | 66984 | $539 | $539–$666 | 117% | $607 | 63 |
| Abdominal ultrasound, complete | 76700 | $152 | $123–$202 | 133% | $188 | 89 |
| Bone density scan (DXA), axial | 77080 | $52 | $42–$75 | 133% | $72 | 90 |
| CT abdomen and pelvis with contrast | 74177 | $390 | $335–$552 | 130% | $510 | 94 |
| CT chest without contrast | 71250 | $231 | $169–$278 | 174% | $272 | 91 |
| Chest X-ray, 2 views | 71046 | $40 | $33–$57 | 121% | $51 | 95 |
| MRI brain without and with contrast | 70553 | $509 | $402–$643 | 161% | $671 | 95 |
| MRI cervical spine without contrast | 72141 | $347 | $245–$474 | 182% | $407 | 91 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $380 | $259–$491 | 186% | $423 | 95 |
| MRI lumbar spine without contrast | 72148 | $357 | $246–$472 | 186% | $410 | 95 |
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 Ohio
Aetna commercial rates are on record at 58 Ohio 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 13 of 17 services and lower for 3. For MRI, lower back, the rate runs from $287 to $2,326 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) | 22 | $26,563 | $16,058–$33,740 | Higher | – |
| C-section delivery (hospital stay) | 21 | Locked | Locked | Higher | Locked |
| Vaginal delivery (hospital stay) | 21 | Locked | Locked | Higher | Locked |
| MRI, lower back | 25 | $1,502 | $287–$2,326 | Higher | $2,244 |
| MRI, knee | 23 | Locked | Locked | Higher | Locked |
| CT, head | 25 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 25 | Locked | Locked | Higher | Locked |
| Screening mammogram | 18 | Locked | Locked | Higher | Locked |
| Colonoscopy, diagnostic | 18 | Locked | Locked | Higher | Locked |
| Upper GI endoscopy with biopsy | 18 | Locked | Locked | Higher | Locked |
| Knee arthroscopy | 18 | Locked | Locked | About the same | Locked |
| Cataract surgery | 19 | Locked | Locked | Higher | Locked |
| Gallbladder removal, laparoscopic | 18 | Locked | Locked | Lower | Locked |
| Knee replacement, outpatient | 18 | Locked | Locked | Lower | Locked |
| Emergency visit, level 4 | 17 | $1,392 | $262–$1,612 | Lower | $1,334 |
| Comprehensive metabolic panel | 23 | Locked | Locked | Higher | Locked |
| Complete blood count | 22 | Locked | Locked | Higher | Locked |
Hospitals with the most published Aetna rates
| Hospital | Joint replacement | MRI lower back | CT abdomen | Colonoscopy | ER level 4 | Vaginal delivery |
|---|---|---|---|---|---|---|
| Ashtabula County Medical Center | $19,962 | Locked | Locked | Locked | Locked | Locked |
| Bethesda North Hospital | $33,740 | Locked | Locked | Locked | Locked | Locked |
| Clinton Memorial Hospital | $33,740 | Locked | Locked | Locked | Locked | Locked |
| Good Samaritan Hospital | $33,740 | Locked | Locked | Locked | Locked | Locked |
| Mccullough-hyde Memorial Hospital | $33,740 | Locked | Locked | Locked | Locked | Locked |
| Uh Ahuja Medical Center | $23,909 | Locked | Locked | Locked | Locked | Locked |
| Uh Conneaut Medical Center | $26,563 | Locked | Locked | Locked | Locked | Locked |
| Uh Elyria Medical Center | $26,563 | Locked | Locked | Locked | Locked | Locked |
| Uh Geneva Medical Center | $26,563 | Locked | Locked | Locked | Locked | Locked |
| Uh Parma Medical Center | $26,563 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 21%, fee schedules 36%, per diem 0%, percent of billed charges 25%, other 18% of Aetna's published commercial rates for these services in Ohio.
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 Ohio
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Other insurers (regional and local plans) | 486 | 35% | $9,434 | 4.0% |
| Anthem (Elevance Health) | 395 | 28% | $6,059 | 3.0% |
| UnitedHealthcare | 254 | 18% | $6,059 | 3.3% |
| Cigna | 182 | 13% | $4,365 | 5.0% |
| Aetna | 108 | 8% | $5,877 | 1.4% |
| Kaiser Permanente | 72 | 5% | $9,657 | 3.4% |
| Blue Cross Blue Shield | 56 | 4% | $6,144 | 4.4% |
| Humana | 20 | 1% | $2,090 | 4.7% |
Aetna in other states
FAQ
How many Ohio employers have Aetna health insurance?
108 employer health plans in Ohio reported a Aetna major-medical contract in their 2024 filings, covering 54,917 persons. Self-funded plans that Aetna only administers are not counted.
What is Aetna's share of the Ohio insured employer market?
8% of insured large employer health plans, 5th of 8 carrier groups by plan count.
How much do brokers earn on Aetna plans in Ohio?
Where broker or agent pay was reported, the median was 1.4% of premium (3.6% across all carriers in Ohio).
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 108 Ohio 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: 95 contracts with 20+ persons covered and a reported premium; broker percentages use the 74 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 Ohio hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.