CMS Price Transparency Data

Blood transfusion

Facility: Baptist Hospital of Miami

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $507
Cash Discount Price: $851
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Baptist Hospital of Miami is $507. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $851. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.12x the Medicare baseline. Located in 8900 N Kendall Dr, Miami, FL.

Cash / Self-Pay

$851

Average discount available for prompt cash payment at this facility.

Insurance Median

$507

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: $851 (189%)

Insurance Median: $507 (112%)

Cash: $851 (189% of Medicare)

Ins. Median: $507 (112% 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
Vista	$173	38%
Medicare (plans)	$184 - $622	41%
Blue Cross Blue Shield	$191 - $848	42%
Medica Health Plan	$199 - $493	44%
Humana	$201 - $502	45%
Avmed	$203 - $644	45%
Aetna	$205 - $1,047	45%
Leon Medical	$206 - $516	46%
Cigna	$210 - $1,047	47%
Amerigroup	$275	61%
Medicaid / KanCare	$275 - $303	61%
UnitedHealthcare	$289 - $1,309	64%
Wellcare	$289	64%
Sunshine State	$292	65%
Non Contracted	$480	106%
Amerihealth	$589	131%
International	$851	189%
Dimension Health Plan	$982 - $1,178	218%
Affordable	$1,113	247%
Phcs	$1,178	261%
Quality Health	$1,178	261%

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 $851.
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 Baptist Hospital of Miami 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.