Aetna employer health plans in Texas
Who Aetna insures among Texas 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 Texas at a glance
What the data shows
Aetna insures 190 employer health plans in Texas (5% of 3,599 insured large plans), 6th of 8 carrier groups; Blue Cross Blue Shield (1,804), UnitedHealthcare (734) hold more.
Aetna has shrunk 29% in Texas since 2020, from 268 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (104 plans); 23 cover 1,000 or more.
Median premium per person covered was $6,075, 3% above the Texas all-carrier median of $5,901. Benefit design and group mix differ, so this is not a price comparison.
71% of these plans reported broker or agent pay on their Aetna contracts; where paid, the median was 3.9% of premium (middle half 0.8%–5.9%).
In Aetna commercial, 28 of the 50 Employer 50 services have a Texas benchmark, at a median of 104% of Medicare across those services.
At Texas hospitals, Aetna's commercial rates run higher than other carriers' at the same hospital for 7 of 17 services; a hip or knee replacement stay has a median rate of $21,446 across 88 hospitals.
Aetna plans in Texas, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 268 | 129,258 | 8% | $4,983 |
| 2021 | 234 | 167,566 | 7% | $5,192 |
| 2022 | 305 | 269,695 | 9% | $5,580 |
| 2023 | 271 | 232,435 | 7% | $5,419 |
| 2024 | 190 | 199,903 | 5% | $6,075 |
| 2025 (partial) | 112 | 174,647 | 4% | $6,123 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 39 | 21% |
| 100–499 | 104 | 55% |
| 500–999 | 24 | 13% |
| 1,000–4,999 | 16 | 8% |
| 5,000 or more | 7 | 4% |
Premiums and broker pay
| Measure | Aetna | All carriers, Texas |
|---|---|---|
| Median premium per person covered | $6,075 | $5,901 |
| Premium per person, middle half | $4,396–$7,753 | $4,055–$7,555 |
| Plans reporting broker or agent pay | 71% | 85% |
| Median broker pay, % of premium | 3.9% | 4.8% |
| Broker pay, middle half | 0.8%–5.9% | 3.4%–6.0% |
| Median broker pay per person covered | $88 | $258 |
Industries
Aetna's Texas employer clients are concentrated in manufacturing (39 plans) and professional and technical services (34), followed by health care and social assistance (17).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 39 | 21% |
| Professional and technical services | 34 | 18% |
| Health care and social assistance | 17 | 9% |
| Construction | 11 | 6% |
| Administrative and support services | 11 | 6% |
| Finance and insurance | 10 | 5% |
Aetna employer clients in Texas
183 employers in Texas have a Aetna major-medical contract, 23 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 Texas
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $289 | $230–$403 | 101% | $385 | 77 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $68 | $55–$90 | 101% | $91 | 82 |
| Electrocardiogram (EKG), complete | 93000 | $14 | $11–$20 | 93% | $22 | 89 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $377 | $345–$569 | 88% | $429 | 75 |
| Treadmill stress test, complete | 93015 | $69 | $56–$95 | 93% | $96 | 71 |
| Cataract removal with lens implant | 66984 | $602 | $548–$747 | 130% | $664 | 90 |
| Abdominal ultrasound, complete | 76700 | $42 | $35–$58 | 112% | $56 | 93 |
| Bone density scan (DXA), axial | 77080 | $11 | $8–$13 | 114% | $14 | 93 |
| CT abdomen and pelvis with contrast | 74177 | $369 | $321–$466 | 123% | $427 | 96 |
| CT chest without contrast | 71250 | $189 | $154–$275 | 143% | $255 | 92 |
| Chest X-ray, 2 views | 71046 | $35 | $28–$46 | 105% | $40 | 95 |
| MRI brain without and with contrast | 70553 | $491 | $406–$624 | 155% | $598 | 96 |
| MRI cervical spine without contrast | 72141 | $375 | $262–$505 | 197% | $372 | 96 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $377 | $277–$526 | 185% | $367 | 94 |
| MRI lumbar spine without contrast | 72148 | $375 | $262–$496 | 196% | $370 | 98 |
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 Texas
Aetna commercial rates are on record at 216 Texas 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 7 of 17 services and lower for 9. For MRI, lower back, the rate runs from $213 to $3,027 across 91 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) | 88 | $21,446 | $12,582–$36,226 | Lower | – |
| C-section delivery (hospital stay) | 95 | Locked | Locked | Higher | Locked |
| Vaginal delivery (hospital stay) | 94 | Locked | Locked | Higher | Locked |
| MRI, lower back | 91 | $1,068 | $213–$3,027 | Lower | $3,529 |
| MRI, knee | 87 | Locked | Locked | Lower | Locked |
| CT, head | 91 | Locked | Locked | Lower | Locked |
| CT, abdomen and pelvis | 91 | Locked | Locked | Lower | Locked |
| Screening mammogram | 62 | Locked | Locked | Higher | Locked |
| Colonoscopy, diagnostic | 69 | Locked | Locked | Higher | Locked |
| Upper GI endoscopy with biopsy | 69 | Locked | Locked | Higher | Locked |
| Knee arthroscopy | 74 | Locked | Locked | Lower | Locked |
| Cataract surgery | 74 | Locked | Locked | Lower | Locked |
| Gallbladder removal, laparoscopic | 76 | Locked | Locked | Lower | Locked |
| Knee replacement, outpatient | 73 | Locked | Locked | Lower | Locked |
| Emergency visit, level 4 | 61 | $3,001 | $565–$4,142 | About the same | $3,650 |
| Comprehensive metabolic panel | 83 | Locked | Locked | Higher | Locked |
| Complete blood count | 84 | 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 |
|---|---|---|---|---|---|---|
| Corpus Christi Medical Center Bayview | $17,401 | Locked | Locked | Locked | Locked | Locked |
| Doctor's Hospital At Renaissance | $39,561 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Clear Lake | $20,681 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Conroe | $20,681 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Kingwood | $20,681 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Medical Center | $21,938 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Northwest Medical Center | $21,938 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Pearland Medical Center | $20,681 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Southeast | $21,675 | Locked | Locked | Locked | Locked | Locked |
| Hca Houston Healthcare Tomball | $21,938 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 39%, fee schedules 13%, per diem 30%, percent of billed charges 13%, other 5% of Aetna's published commercial rates for these services in Texas.
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 Texas
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Blue Cross Blue Shield | 1,804 | 50% | $6,240 | 4.3% |
| UnitedHealthcare | 734 | 20% | $5,375 | 5.1% |
| Cigna | 654 | 18% | $2,700 | 7.7% |
| Other insurers (regional and local plans) | 350 | 10% | $3,674 | 6.0% |
| Kaiser Permanente | 271 | 8% | $9,124 | 3.9% |
| Aetna | 190 | 5% | $6,075 | 3.9% |
| Anthem (Elevance Health) | 33 | 1% | $6,897 | 4.8% |
| Humana | 11 | 0% | $3,665 | 5.3% |
Aetna in other states
FAQ
How many Texas employers have Aetna health insurance?
190 employer health plans in Texas reported a Aetna major-medical contract in their 2024 filings, covering 199,903 persons. Self-funded plans that Aetna only administers are not counted.
What is Aetna's share of the Texas insured employer market?
5% of insured large employer health plans, 6th of 8 carrier groups by plan count.
How much do brokers earn on Aetna plans in Texas?
Where broker or agent pay was reported, the median was 3.9% of premium (4.8% across all carriers in Texas).
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 190 Texas 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: 165 contracts with 20+ persons covered and a reported premium; broker percentages use the 133 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 Texas hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.