Molina Healthcare
What does Molina Healthcare actually pay hospitals? We analyzed 742 negotiated rates from 4 hospitals across 2 states.
Is Molina Healthcare Expensive or Cheap?
Based on our analysis of 742 negotiated rates, Molina Healthcare is somewhat more expensive than average compared to other insurance companies in our database. They pay roughly the same or less than Medicare for equivalent services.
Top Procedures with Negotiated Rates
Procedures where Molina Healthcare has the most rate data
| Code | Description | Rates | Avg Rate | Min | Max |
|---|---|---|---|---|---|
| 85025 | Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet count) and automated differential WBC count | 14 | $9 | $7 | $17 |
| 71046 | Radiologic examination, chest; 2 views | 14 | $48 | $37 | $135 |
| 72100 | Radiologic examination, spine, lumbosacral; 2 or 3 views | 14 | $58 | $44 | $172 |
| 99281 | HC ED LEVEL 1 | 14 | $135 | $87 | $140 |
| 71250 | HC CT CHEST WO CONTRAST | 14 | $135 | $105 | $406 |
| 99282 | Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making | 14 | $141 | $140 | $156 |
| 71260 | HC CT CHEST W CONTRAST | 14 | $210 | $176 | $501 |
| 99283 | HC ED LEVEL 3 | 14 | $204 | $177 | $273 |
| 99284 | HC ED LEVEL 4 | 14 | $320 | $226 | $420 |
| 99285 | HC ED LEVEL 5 | 14 | $407 | $286 | $605 |
| 62322 | Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, i | 14 | $334 | $289 | $879 |
| 22612 | Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) | 13 | $8,556 | $7,756 | $18,156 |
| 71045 | Radiologic examination, chest; single view | 10 | $41 | $28 | $101 |
| 73590 | Radiologic examination; tibia and fibula, 2 views | 10 | $45 | $35 | $87 |
| 20611 | Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting | 10 | $90 | $52 | $291 |
| 25600 | Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; without manipulation | 10 | $117 | $94 | $237 |
| 72125 | HC CT SPINE CERVICAL WO CONTR | 10 | $161 | $105 | $588 |
| 72131 | HC CT SPINE LUMBAR WO CONTR | 10 | $161 | $105 | $588 |
| 12031 | Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less | 10 | $183 | $157 | $394 |
| 72133 | HC CT SPINE LUMBAR WOW CONTR | 10 | $245 | $176 | $735 |
| 70551 | Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material | 10 | $305 | $222 | $1,033 |
| 73721 | Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material | 10 | $278 | $230 | $700 |
| 73221 | Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s) | 10 | $271 | $230 | $634 |
| 70552 | Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s) | 10 | $350 | $307 | $693 |
| 72149 | Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; with contrast material(s) | 10 | $348 | $307 | $674 |
Hospitals with Molina Healthcare Rates
Hospitals where we have negotiated rate data for Molina Healthcare
| Hospital | State | Rates | Procedures | Avg Rate | Range |
|---|---|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | KY | 206 | 117 | $9,608 | $8 - $229,941 |
| HCA HOUSTON HEALTHCARE MEDICAL CENTER | TX | 202 | 65 | $12,466 | $7 - $412,960 |
| HCA HOUSTON HEALTHCARE TOMBALL | TX | 189 | 60 | $12,536 | $7 - $404,133 |
| HCA HOUSTON HEALTHCARE CLEAR LAKE | TX | 145 | 47 | $7,663 | $10 - $306,513 |
About This Data
These rates are from hospital Machine-Readable Files (MRFs) required by the CMS Hospital Price Transparency Rule. They reflect specific hospital-payer contracts and may not represent your actual cost, which depends on your specific plan, deductible, copay, coinsurance, and network status. Data sources include CommonSpirit Health, HCA Healthcare, and Kaiser Permanente filings.