Aetna employer health plans in Virginia
Who Aetna insures among Virginia 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 Virginia at a glance
What the data shows
Aetna insures 103 employer health plans in Virginia (9% of 1,209 insured large plans), 7th of 8 carrier groups; Cigna (380), Anthem (Elevance Health) (282) hold more.
Aetna has shrunk 6% in Virginia since 2020, from 109 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (49 plans); 8 cover 1,000 or more.
Median premium per person covered was $5,386, 22% below the Virginia all-carrier median of $6,940. Benefit design and group mix differ, so this is not a price comparison.
70% of these plans reported broker or agent pay on their Aetna contracts; where paid, the median was 3.2% of premium (middle half 0.9%–6.5%).
In Aetna commercial, 28 of the 50 Employer 50 services have a Virginia benchmark, at a median of 119% of Medicare across those services.
At Virginia hospitals, Aetna's commercial rates run higher than other carriers' at the same hospital for 5 of 14 services; a hip or knee replacement stay has a median rate of $16,394 across 20 hospitals.
Aetna plans in Virginia, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 109 | 60,225 | 9% | $5,116 |
| 2021 | 114 | 66,008 | 9% | $5,316 |
| 2022 | 113 | 74,237 | 9% | $5,756 |
| 2023 | 141 | 93,360 | 11% | $5,689 |
| 2024 | 103 | 86,237 | 9% | $5,386 |
| 2025 (partial) | 54 | 71,959 | 7% | $5,705 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 30 | 29% |
| 100–499 | 49 | 48% |
| 500–999 | 16 | 16% |
| 1,000–4,999 | 6 | 6% |
| 5,000 or more | 2 | 2% |
Premiums and broker pay
| Measure | Aetna | All carriers, Virginia |
|---|---|---|
| Median premium per person covered | $5,386 | $6,940 |
| Premium per person, middle half | $2,743–$7,705 | $4,522–$10,219 |
| Plans reporting broker or agent pay | 70% | 79% |
| Median broker pay, % of premium | 3.2% | 3.9% |
| Broker pay, middle half | 0.9%–6.5% | 2.5%–5.7% |
| Median broker pay per person covered | $64 | $255 |
Industries
Aetna's Virginia employer clients are concentrated in professional and technical services (41 plans) and health care and social assistance (12), followed by other services (11).
| Industry | Plans | Share |
|---|---|---|
| Professional and technical services | 41 | 40% |
| Health care and social assistance | 12 | 12% |
| Other services | 11 | 11% |
| Construction | 6 | 6% |
| Educational services | 5 | 5% |
| Manufacturing | 5 | 5% |
Aetna employer clients in Virginia
97 employers in Virginia 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 Virginia
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Diagnostic heart catheterization with coronary angiography | 93458 | $351 | $275–$419 | 122% | $454 | 82 |
| Echocardiogram, transthoracic complete with Doppler | 93306 | $253 | $221–$295 | 129% | $331 | 89 |
| Electrocardiogram (EKG), complete | 93000 | $20 | $18–$23 | 128% | $26 | 90 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $467 | $425–$552 | 109% | $627 | 86 |
| Treadmill stress test, complete | 93015 | $91 | $79–$112 | 124% | $121 | 82 |
| Cataract removal with lens implant | 66984 | $687 | $627–$806 | 148% | $555 | 76 |
| Abdominal ultrasound, complete | 76700 | $45 | $36–$61 | 119% | $57 | 170 |
| Bone density scan (DXA), axial | 77080 | $67 | $40–$96 | 169% | $72 | 167 |
| CT abdomen and pelvis with contrast | 74177 | $371 | $315–$454 | 124% | $475 | 167 |
| CT chest without contrast | 71250 | $222 | $169–$287 | 168% | $281 | 171 |
| Chest X-ray, 2 views | 71046 | $11 | $10–$14 | 112% | $15 | 167 |
| MRI brain without and with contrast | 70553 | $522 | $440–$635 | 165% | $727 | 176 |
| MRI cervical spine without contrast | 72141 | $475 | $370–$558 | 249% | $424 | 174 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $475 | $370–$574 | 232% | $433 | 175 |
| MRI lumbar spine without contrast | 72148 | $475 | $366–$572 | 248% | $431 | 177 |
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 Virginia
Aetna commercial rates are on record at 35 Virginia 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 5 of 14 services and lower for 5. For MRI, lower back, the rate runs from $813 to $2,994 across 12 hospitals.
This page shows 3 of the 14 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) | 20 | $16,394 | $14,915–$36,000 | About the same | – |
| C-section delivery (hospital stay) | 20 | Locked | Locked | About the same | Locked |
| Vaginal delivery (hospital stay) | 20 | Locked | Locked | About the same | Locked |
| MRI, lower back | 12 | $1,387 | $813–$2,994 | Higher | $7,811 |
| MRI, knee | 12 | Locked | Locked | Higher | Locked |
| CT, head | 12 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 12 | Locked | Locked | Higher | Locked |
| Screening mammogram | 12 | Locked | Locked | Lower | Locked |
| Knee arthroscopy | 13 | Locked | Locked | Higher | Locked |
| Gallbladder removal, laparoscopic | 15 | Locked | Locked | Lower | Locked |
| Knee replacement, outpatient | 15 | Locked | Locked | Lower | Locked |
| Emergency visit, level 4 | 11 | $3,045 | $2,431–$3,846 | About the same | $3,815 |
| Comprehensive metabolic panel | 13 | Locked | Locked | Lower | Locked |
| Complete blood count | 14 | Locked | Locked | Lower | Locked |
Hospitals with the most published Aetna rates
| Hospital | Joint replacement | MRI lower back | CT abdomen | Colonoscopy | ER level 4 | Vaginal delivery |
|---|---|---|---|---|---|---|
| Chesapeake Regional Medical Center | $35,089 | Locked | Locked | Locked | Locked | Locked |
| Chippenham Hospital | $14,971 | Locked | Locked | Locked | Locked | Locked |
| Dominion Hospital | $14,971 | Locked | Locked | Locked | Locked | Locked |
| Henrico Doctors' Hospital | $14,915 | Locked | Locked | Locked | Locked | Locked |
| Lewisgale Hospital Alleghany | $14,254 | Locked | Locked | Locked | Locked | Locked |
| Lewisgale Hospital Montgomery | $30,020 | Locked | Locked | Locked | Locked | Locked |
| Lewisgale Hospital Pulaski | $14,990 | Locked | Locked | Locked | Locked | Locked |
| Reston Hospital Center | $16,031 | Locked | Locked | Locked | Locked | Locked |
| Spotsylvania Regional Medical Center | $15,544 | Locked | Locked | Locked | Locked | Locked |
| Stonesprings Hospital Center | $16,040 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 25%, fee schedules 14%, per diem 3%, percent of billed charges 58%, other 0% of Aetna's published commercial rates for these services in Virginia.
Employers: see all 14 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 Virginia
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Cigna | 380 | 31% | $7,544 | 5.0% |
| Anthem (Elevance Health) | 282 | 23% | $6,999 | 2.8% |
| UnitedHealthcare | 212 | 18% | $5,957 | 4.2% |
| Other insurers (regional and local plans) | 191 | 16% | $7,246 | 3.1% |
| Blue Cross Blue Shield | 177 | 15% | $7,133 | 4.9% |
| Kaiser Permanente | 157 | 13% | $7,961 | 3.6% |
| Aetna | 103 | 9% | $5,386 | 3.2% |
| Humana | 4 | 0% | $1,538 | 3.1% |
Aetna in other states
FAQ
How many Virginia employers have Aetna health insurance?
103 employer health plans in Virginia reported a Aetna major-medical contract in their 2024 filings, covering 86,237 persons. Self-funded plans that Aetna only administers are not counted.
What is Aetna's share of the Virginia insured employer market?
9% of insured large employer health plans, 7th of 8 carrier groups by plan count.
How much do brokers earn on Aetna plans in Virginia?
Where broker or agent pay was reported, the median was 3.2% of premium (3.9% across all carriers in Virginia).
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 103 Virginia 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: 84 contracts with 20+ persons covered and a reported premium; broker percentages use the 72 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 Virginia hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.