(Bloomberg) -- Humana Inc. shareholders have the most to lose ifthe health insurer gets spit out of the tide of consolidationsweeping the industry.

Speculated as the likeliest target among the top five U.S.managed-care providers, Humana could be left to fend foritself--or forced to take a lower offer than it might like--ifpotential suitors merge with each other instead.

Anthem Inc. had weighed a bid for Humana, but on Saturdayannounced a $47 billion proposal for Cigna Corp. WhileCigna rejected the $184- a-share cashand stock offer, Anthem reiterated it on Monday.

Further complicating the deal drama, both Anthem and Cignacontinue to be in discussions to acquire Humana, according topeople familiar with the matter, who asked not to be identifiedbecause the information is private.

If Anthem and Cigna agree to a deal, Humana could be left with only one suitor:Aetna Inc. In that scenario, Humana doesn’t have muchleverage to push for a higher valuation and a transaction couldhappen below the current share price, according to Christine Arnoldof Cowen Group Inc.

“If Aetna is interested in Humana, these events sure strengthentheir hand at the negotiating table,” said Brian Wright, a NewYork-based analyst at Sterne Agee CRT.

A takeover at a low price may be better than nothing. That couldbe the result if the biggest health insurer of the bunch,UnitedHealth Group Inc., decides to get in the mix and target Aetnafor itself.

Downside risk

After climbing to a record amid growing takeover speculation,Humana stands to fall as much as 40 percent to $120 a share withouta deal, said Chris Rigg of Susquehanna International Group. Thecompany has missed analysts’ earnings estimates for three straightquarters and probably will reduce its guidance for 2015, the NewYork-based analyst said.

“Absent the M&A speculation, it would be significantly below$200,” Rigg said.

Humana fell 6.1 percent to $189.94 a share on Monday in NewYork. UnitedHealth declined 0.1 percent, while Aetna, Anthem andCigna all gained.

UnitedHealth, with a market value of $114 billion, could goafter Aetna to thwart an Aetna-Humana deal. That’s because if Aetnamerged with Humana, the combined company would be too big forUnitedHealth to buy without raising antitrust alarms. AUnitedHealth-Humana deal isn’t an option because of the twocompanies’ significant overlap in Medicare Advantage, theprivate-company policies offered for the government-sponsoredprogram for the elderly.

Still possible

Humana shareholders shouldn’t give up all hope just yet. Arnoldof Cowen says an Aetna-Humana combination is still moreprobable than Aetna-UnitedHealth.

Bank of America analyst Kevin Fischbeck also puts a lowerprobability on UnitedHealth making an acquisition, mostly becauseit doesn’t need one as the biggest and fastest-growing healthinsurer.

For Humana, “I still think the most likely scenario is that theywill get taken out by Aetna,” Rigg of Susquehanna said. Heestimated a takeover valuation in the $200 range, but cautioned abid could be for more like $180 if due diligence shows thatHumana’s earnings are likely to fall.

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