CMS Price Transparency Data

Blood transfusion

Facility: Holmes Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $741
Cash Discount Price: $369
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Holmes Regional Medical Center is $741. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $369. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.64x the Medicare baseline. Located in 1350 S Hickory St, Melbourne, FL.

Cash / Self-Pay

$369

Average discount available for prompt cash payment at this facility.

Insurance Median

$741

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: $369 (82%)

Insurance Median: $741 (164%)

Cash: $369 (82% of Medicare)

Ins. Median: $741 (164% 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
Health First Health Plan	$43 - $440	10%
UnitedHealthcare	$66 - $1,477	15%
Molina Healthcare	$290 - $1,654	64%
Humana	$296 - $1,477	66%
Aetna	$304 - $1,625	67%
Amerigroup	$304 - $1,551	67%
Sunshine Health Plan	$304 - $1,551	67%
Corizon Health	$461	102%
Florida Healthcare Plans	$467	104%
Cigna	$569 - $609	126%
Disney Cruise Line	$886	197%
Prime Heath Services, Inc.	$1,108	246%
Multiplan	$1,182	262%
Florida Blue	$2,616 - $2,802	580%

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 $369.
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 Holmes Regional 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.