US health care giant Anthem has offered to acquire rival Cigna in a deal that could fetch $45 billion, the Wall Street Journal reported Monday.
However, two successive Anthem bids were rebuffed by Cigna chief executive David Cordani, whose desire to lead the combined company has become a "stumbling block" to a deal, the newspaper said.
The last offer, at about $175 per share, according to the Journal, would value Cigna at around $45 billion.
Cigna shares surged 14.7 percent to $157.50, while Anthem gained 2.5 percent to $164.73 in afternoon trade following the report.
Conversations between the two companies come amid a wave of consolidation throughout the health care industry in the wake of the US Affordable Care Act.
Pharmaceutical companies and hospitals have also grown through acquisition as different stakeholders seek to bulk up to improve their bargaining positions with other parties.
Anthem, the second biggest US health care company after UnitedHealth Group, had revenues of $73.8 billion in 2014 and works as the licensee for Blue Cross and Blue Shield plans in several US states.
Cigna had 2014 revenues of $34.9 billion.
Neither Anthem nor Cigna responded immediately to queries for comment.