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Payer price transparency data

Molina

Molina is a health insurer. They report 410 insurance plans covering 200K providers across 140K billing codes.

Source: public Transparency in Coverage filesRefreshed monthly, latest August 202617 monthly releases tracked

Monthly release

410

Plans

XX% vs prior month

200K

Providers (NPIs)

XX% vs prior month

23K

Tax IDs

XX% vs prior month

140K

Billing codes

320M

Rate rows

XX% vs prior month

August 2026 release

What's in Molina's data

A profile of the machine-readable files Molina publishes, after PayerPrice parses and normalizes them.

Billing code types

Distinct codes and rate rows by code system

CodesRows
  • CPT20K310M96%
  • HCPCS120K12M3.8%
  • CDT3.3K950K0.3%
  • RC920270K<0.1%
  • 2929<0.1%

Billing class

Professional vs. institutional rate rows

  • Professional320M100%
  • Institutional230K<0.1%

Negotiation arrangement

How each rate is expressed

  • Rvs280M87%
  • Standard21M6.6%
  • Fee Schedule13M4.0%
  • Ucr2.6M0.8%
  • Negotiated2.6M0.8%
  • Asc960K0.3%
  • Per Unit480K0.2%
  • Flat Rate320K<0.1%
  • Per Diem33K<0.1%
  • Case Rate14K<0.1%

Plan identifiers

HIOS IDs mark individual and small-group plans; EINs mark employer plans

  • HIOS ID410100%

Providers by type

Distinct NPIs by entity type

  • Individual (Type 1)200K96%
  • Organization (Type 2)7.4K3.6%

Tax IDs by type

How provider groups are identified

  • EIN23K100%

Top states

States with the most providers in network

  • Florida39K
  • Washington35K
  • Texas32K
  • Illinois16K
  • Utah11K
  • New Mexico11K

Top specialties

Provider taxonomies with the most NPIs

  • Family Nurse Practitioner15K
  • Physical Therapist9.7K
  • Certified Registered Nurse Anesthetist9.7K
  • Family Medicine Physician9.3K
  • Physician Assistant8.7K
  • Internal Medicine Physician8.4K

These are the files. Want the rates inside them?

Look up Molina's negotiated rates by provider, TIN, billing code and plan.

Month-over-month history

Track how network size and rate volume change with each monthly release.

MonthPlansNPIsTax IDsBilling codesRate rows
August 2026410200K23K140K320M
July 2026660270K29K140K78M
June 202625020K2.2K29K3.9M
May 2026————
April 2026————

Data quality scorecard

6/6Good

This payer meets all 6 data quality criteria — their transparency files are comprehensive and well-structured.

Evaluated on the August 2026 release.

  • Professional & Institutional Rates

    Data includes both professional and institutional billing class rates

  • Valid Tax IDs

    More than 80% of Tax IDs are EIN or NPI (Organization) type

  • HIOS Plan

    Data includes at least one HIOS-identified plan

  • Low Derived/Percentage Rates

    Less than 10% of negotiation entries are derived or percentage type

  • Standard Code Coverage

    Sufficient CPT and HCPCS code coverage with low proportion of LOCAL entries

  • Common Taxonomies

    NPIs in the dataset cover at least 50 distinct provider taxonomies

How the score works

Each monthly release is checked against six criteria. 5–6 passing criteria rate Good, 3–4 rate Acceptable, and 0–2 rate Poor.

Behavioral, RX, and other specialty networks may not pass all criteria but can still contain complete and usable data.

Access the data

Molina's negotiated rates, in the tools your team already uses

PayerPrice turns raw transparency files into one clean, normalized dataset across 180+ payers, refreshed every month. Pick how you want to work with it.

UI

Web app

Search Molina's rates by code, provider or market and export the results. No setup required.

Start free trial
API

REST API

Pull negotiated rates, providers and benchmarks into your own products and pipelines.

Explore the API
SQL

Snowflake & Databricks

Query the full normalized dataset with SQL or PySpark, shared directly into your warehouse.

See data sharing
AI

MCP server

Ask Claude, Cursor or your own agents questions like "What does Molina pay for CPT 99213 near me?"

Read the MCP docs
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Frequently asked questions

About Molina's price transparency data.

What price transparency data does Molina publish?

Molina's August 2026 Transparency in Coverage files list 410 plans, 200K providers (NPIs), 23K tax IDs and 140K billing codes, for 320M negotiated rate rows in total.

Which states does Molina's network cover?

Molina's files include providers in 51 states. The states with the most in-network providers are Florida, Washington, Texas, Illinois, Utah.

How often is Molina's data updated?

Payers must post updated machine-readable files every month. PayerPrice processes Molina's files monthly; the latest processed release is August 2026, and 17 monthly releases are available.

What is the Transparency in Coverage rule?

Since July 2022, the federal Transparency in Coverage rule has required most group health plans and health insurers to publish machine-readable files of their in-network negotiated rates and out-of-network allowed amounts, updated monthly. These files are the source for the data on this page.

How can I access Molina's negotiated rates?

Start a free PayerPrice trial to search Molina's rates in the web app, or book a demo to get the full dataset through the REST API, SQL in Snowflake or Databricks, or AI assistants through the PayerPrice MCP server.