CMS Price Transparency Data

Blood transfusion

Facility: Southeast Health Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $423
Cash Discount Price: $502
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Southeast Health Medical Center is $423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $502. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.94x the Medicare baseline. Located in 1108 Ross Clark Circle, Dothan, AL.

Cash / Self-Pay

$502

Average discount available for prompt cash payment at this facility.

Insurance Median

$423

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$450.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $450.73 (100%)

Cash / Self-Pay: $502 (111%)

Insurance Median: $423 (94%)

Cash: $502 (111% of Medicare)

Ins. Median: $423 (94% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $450.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Viva Health	$400 - $423	89%
Aetna	$423	94%
Blue Cross Blue Shield	$423	94%
Care Improvement Plus	$423	94%
Cigna	$423	94%
Humana	$423 - $475	94%
Security Health	$423	94%
Simpra Advantage	$423	94%
UnitedHealthcare	$423 - $572	94%
Wellcare	$423	94%
Ambetter / Centene	$571	127%
Direct Connect Contracting	$592	131%
Naphcare	$782	173%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $502.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 36430.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Southeast Health Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 36430.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.