OptumHealth Care Solutions
What does OptumHealth Care Solutions actually pay hospitals? We analyzed 252 negotiated rates from 2 hospitals across 2 states.
Is OptumHealth Care Solutions Expensive or Cheap?
Based on our analysis of 252 negotiated rates, OptumHealth Care Solutions is significantly cheaper 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 OptumHealth Care Solutions 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 | 4 | $99 | $7 | $221 |
| 36415 | Collection of venous blood by venipuncture | 4 | $22 | $8 | $46 |
| 80053 | Comprehensive metabolic panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Calcium, total (82310) Carbon dioxide (bicarbonate) (82374) Chloride (82435) Creatinine (8 | 4 | $495 | $9 | $1,116 |
| 97110 | Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility | 4 | $133 | $22 | $289 |
| 97140 | Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes | 4 | $123 | $24 | $266 |
| 97530 | Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes | 4 | $109 | $27 | $231 |
| 97112 | Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular reeducation of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing act | 4 | $125 | $29 | $266 |
| 99292 | HC ED CRITICAL CARE ADDL | 3 | $98 | $54 | $166 |
| 99213 | HC CLINIC VISIT LEVEL 3 EST | 3 | $206 | $114 | $350 |
| 25600 | HC CL TX COLLES FX W/O MNP | 3 | $225 | $125 | $383 |
| 99202 | HC CLINIC VISIT LEVEL 2 NEW | 3 | $230 | $128 | $392 |
| 99214 | HC CLINIC VISIT LEVEL 4 EST | 3 | $234 | $130 | $398 |
| 99215 | HC CLINIC VISIT LEVEL 5 EST | 3 | $243 | $135 | $412 |
| 99203 | HC CLINIC VISIT LEVEL 3 NEW | 3 | $289 | $160 | $491 |
| 99204 | HC CLINIC VISIT LEVEL 4 NEW | 3 | $331 | $184 | $563 |
| 99205 | HC CLINIC VISIT LEVEL 5 NEW | 3 | $349 | $194 | $594 |
| 99281 | HC CEC LEVEL 1 | 3 | $350 | $195 | $596 |
| 73060 | HC XR HUMERUS MIN 2 VIEWS | 3 | $501 | $278 | $852 |
| 12001 | HC REPAIR SIMSCLP 2.5CM/< | 3 | $503 | $279 | $855 |
| 12011 | HC REPAIR SIM FACE 2.5CM/< | 3 | $542 | $301 | $922 |
| 64484 | HC INJ(S) FORAMEN LUMB/SAC ADL | 3 | $597 | $332 | $1,015 |
| 71045 | HC XR CHEST 1 VIEW | 3 | $607 | $337 | $1,031 |
| 12002 | HC REPAIR SIM SCLP 2.6-7.5CM | 3 | $659 | $366 | $1,120 |
| 73590 | HC XR LEG TIBIA & FIBULA 2 VWS | 3 | $673 | $374 | $1,144 |
| 73562 | HC XR KNEE 3 VIEWS | 3 | $700 | $389 | $1,191 |
Hospitals with OptumHealth Care Solutions Rates
Hospitals where we have negotiated rate data for OptumHealth Care Solutions
| Hospital | State | Rates | Procedures | Avg Rate | Range |
|---|---|---|---|---|---|
| St. Luke's Sugar Land Hospital | TX | 204 | 68 | $2,566 | $15 - $17,334 |
| HCA HEALTHONE PRESBYTERIAN ST LUKES | CO | 48 | 44 | $30,852 | $7 - $232,973 |
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.