The price Molina Healthcare has already agreed to pay each doctor, for the same procedure, summarised by state. Prices for one procedure can differ several-fold between two practices a few miles apart.
Molina Healthcare sells individual and family plans on the ACA marketplace; these are its Ohio plans' prices.
How its prices were read. Federal rules let an insurer label each price with one of five types (a dollar amount, a percentage of the bill, a daily rate and so on). Almost all of Molina's Ohio prices - 99% of them - carry labels of Molina's own instead: RVS, UCR and FFS. The rules do not define these and Molina does not explain them, so we tested them against Medicare's fee schedule. RVS and UCR prices rise and fall with what Medicare pays for each service (correlation 0.97 and 0.94 across about 50 services), at around 0.9 and 0.45 times Medicare: they behave as dollar prices, and are shown as such. FFS values are 0, 50 or 100 whatever the service - a percentage, not a price - and are left out. This reading is ours, not Molina's.
Since 2021, a federal rule called Transparency in Coverage has required health insurers to publish, every month, the rate they have negotiated with every provider in their network, for every billing code. Not an average, not a range — the actual contracted price, provider by provider.
The catch is that nobody can read them. They are published as raw JSON files running to gigabytes each, one per network, with providers referenced by numeric id rather than by name. They satisfy the rule without being of the slightest use to a patient. These maps are built directly from those files: every number here was published by the insurer, and nothing is estimated, modelled, or averaged from a survey.
Molina Healthcare publishes its files at its price transparency page. From there this build read 1 index file naming 12,040 health plans (12,040 individual-market), then downloaded 300 in-network rate files (8.0 GB) on 2026-10-21.
From those, 284,609 price entries for 94 common procedures were extracted, each provider looked up in the federal NPPES registry for their practice address, and the results grouped by zip code.
That is a count of entries, not of prices. An entry is one price together with the list of providers it applies to, and insurers write their files very differently: some state a price once for a whole network, others repeat it for every practice. Here a typical Molina Healthcare entry applies to 216 providers (833 on average), so the 284,609 entries come to about 237 million provider-level prices (counting each network file separately). A big or small entry count says how an insurer writes its files, not how many prices it has — compare insurers on the maps, not on this number.
Everything here is public and verifiable:
Each price is what this insurer pays that provider for that billing code — the price in the setting where that procedure is normally done: an office visit in an office, an emergency visit in the emergency department, a hospital stay as an inpatient, a colonoscopy at a surgery center or hospital outpatient department. Procedures done everywhere, such as lab tests and scans, show every in-person setting. Telehealth rates are excluded, and so are prices for only part of a service: a scan's reading fee or equipment fee alone, an assistant surgeon's fee, a procedure that was not completed. Each procedure below, and each map, says which setting it shows.
It is not what you will be billed. What you pay depends on your deductible, copay and coinsurance; a visit usually includes more than one billing code; and a hospital-based practice may add a facility fee. Use these maps to compare providers, not to predict a bill.
“x Medicare” compares each price with what original Medicare pays a doctor for the same service in the same state under its physician fee schedule (RVU26D, in force from 2026-10-01). Insurers write their contracts as a share of Medicare, so 1.3x means the insurer pays 30% more than Medicare would; Medicare Advantage plans generally pay close to 1.0x. Across the 85 procedures below that Medicare prices, Molina Healthcare’s typical price is about what Medicare pays; each procedure shows its own figure, and each map shows it state by state. Lab tests are compared with Medicare’s lab fee schedule and hospital stays with what Medicare paid hospitals in the state per stay; each map says which.
Care in a hospital or surgery center usually comes as two separate bills: the doctor’s fee (the “professional” fee, for the doctor’s own work) and the facility fee (the hospital or surgery center’s charge for the room, nurses and equipment). The facility fee is often the larger of the two, and many people do not know it is coming. A visit to an independent doctor’s office normally has no facility fee, but a clinic owned by a hospital may add one.
Insurers publish the two separately. Every procedure below, and every map, says which one it shows: here 94 show doctor's fee.
A visit is billed as several codes, each priced on its own. An emergency visit for chest pain is the visit code twice over (the doctor’s fee and the hospital’s facility fee), then blood tests, an EKG and a chest X-ray — and the tests vary more between hospitals than the visit code does. These are the typical totals Molina Healthcare would pay in its largest states, adding up the median of each part; a part the files do not price there is left out and named.
Molina Healthcare lists clinicians individually: 92% of the 35,904 provider IDs (NPIs) it names are individual doctors, nurse practitioners and therapists; the rest are practices, clinics and hospitals. “Providers” counts those IDs. For each procedure, “providers” counts the clinicians whose specialty performs it, plus practices, clinics and hospitals. Insurers attach their whole fee schedule to every contracted provider, so their files name far more — family doctors and nurse practitioners listed at a price for a brain scan they will never do — and each map says how many were named.
Some prices this insurer’s members pay are published somewhere else, so they are not on these maps:
Molina Healthcare’s 1 index file name 300 in-network rate files. 300 were downloaded and 300 read — every one. 134 files held no prices for the procedures mapped here. The files also hold 24,205 price records in code sets this site does not read (REV 24,205) — revenue codes, dental codes and case-rate or bundled arrangements, where some of the highest-cost care (maternity, transplants, cancer treatment) can be contracted.
These maps summarise a whole state. Prices vary far more between two practices in one town than between two states, so a statewide median tells you what a procedure broadly costs, not what any particular provider charges. Zip-code and provider-level detail is not published here, but this data can be requested.
One insurer, one month, and only commercial plans — the rules do not cover Medicaid or Medicare Advantage, so those prices are not published at all. Out-of-network allowed amounts are published separately and are not included. Providers are placed at the practice address they registered with the federal NPI registry, which is sometimes a billing office rather than where they actually see patients.
Every state is a circle, shaded by what that procedure typically costs there and sized by how many providers report a price. Click one for the lowest, typical and highest price in that state, and the middle half of the range - the spread matters more than the median.