CMS Price Transparency Data

Blood transfusion

Facility: Flowers Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $2,750
  • Cash Discount Price: $920
  • vs. Medicare Baseline: 6.10x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Flowers Hospital is $2,750. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $920. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 6.10x the Medicare baseline. Located in 4370 West Main Street, Dothan, AL.
Cash / Self-Pay
$920

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,750

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: $920 (204%)
Insurance Median: $2,750 (610%)
Cash: $920 (204% of Medicare)
Ins. Median: $2,750 (610% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 610% of the Medicare baseline (a markup of 510%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Veterans Eval Services $36 8%
Alabama Rehab $191 42%
Medicaid / KanCare $191 - $287 42%
UnitedHealthcare $347 - $673 77%
Tricare $404 90%
Blue Cross Blue Shield $418 - $674 93%
Humana $418 93%
Medicare (plans) $418 93%
Node Viva Mcr Adv $418 93%
Select Health $422 94%
Compassionate Hands $425 94%
Covenant Hospice $425 94%
Dayspring Hospice $425 94%
Node Champva $425 94%
Node Hospice Non Par $425 94%
Node Va $425 94%
Southern Care Hospice $425 94%
Vistacare Hospice $425 94%
Wiregrass Hospice $425 94%
Care Improvement Plus $427 95%
Cigna $427 95%
Node Devoted Health Mcr Adv $427 95%
Node Clover Health Mcr Adv $429 95%
Aetna $431 - $3,602 96%
Node Wellcare Mcr Adv $434 96%
Eon Health Care $439 97%
Prime Health $447 - $3,481 99%
Node Us Dept Of Labor $531 118%
Self Pay $550 - $1,480 122%
Ambetter / Centene $638 142%
Occunet $744 165%
S & S Healthcare $917 - $1,234 203%
Choicecare Commercial $1,283 - $1,727 285%
American Employee Alliance $1,466 - $1,974 325%
Coventry Healthcare $1,833 - $3,768 407%
Viva Health $2,200 - $2,960 488%
Multiplan $2,383 - $3,947 529%
Standard Textile $2,566 - $3,454 569%
Alamed Wc $2,587 - $3,481 574%
Health Choice $2,676 - $3,602 594%
Equian $2,750 - $3,890 610%
Qhp $2,750 - $3,700 610%
Novanet $2,933 - $3,947 651%
Alabama Work Comp $3,043 - $4,095 675%
Ccn/Mednet Ppo $3,116 - $4,194 691%
Corvel $3,116 - $4,194 691%
Industry Buying Group $3,116 - $4,194 691%
Galaxy Health $3,300 - $4,441 732%
Health Payors Org $3,300 - $4,441 732%
National Provider Net $3,300 - $4,441 732%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4370 West Main Street, Dothan, AL 36302
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals