CMS Price Transparency Data

Blood transfusion

Facility: North Shore Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $534
  • Cash Discount Price: $1,429
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at North Shore Medical Center is $534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,429. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.18x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$1,429

Average discount available for prompt cash payment at this facility.

Insurance Median
$534

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: $1,429 (317%)
Insurance Median: $534 (118%)
Cash: $1,429 (317% of Medicare)
Ins. Median: $534 (118% 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.

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
Aetna $38 - $1,142 8%
Healthsun Health Plans $46 - $444 10%
Self Pay/Uninsured $54 - $529 12%
Employer Direct Healthcare $55 - $430 12%
Oscar Health Plan Hix $78 - $97 17%
Imagine Health $127 - $159 28%
Cigna $221 - $793 49%
Avmed Broad Network $267 - $333 59%
Humana $279 - $633 62%
Medicaid / KanCare $279 - $1,586 62%
UnitedHealthcare $282 - $534 63%
Veterans Administration Mill Bill $296 66%
Medicare (plans) $381 - $1,586 85%
Leon Health Inc $421 93%
Devoted Health $423 94%
Tricare $426 95%
Hospice Other $430 95%
Veterans Administration Vaccn $430 95%
Longevity Health Plan $452 100%
Florida Pace Centers $508 113%
Bright Health Management Commercial $516 114%
Centurion Prison $529 117%
Bc/Bs Of Fl Phs $659 - $822 146%
Avmed Exchange $753 167%
Magellan Behavioral Health $763 - $952 169%
Ambetter / Centene $796 177%
Molina Marketplace Program Exchange $819 182%
Dimensions International $826 - $1,031 183%
Auto Insurance $860 191%
First Health $864 - $1,078 192%
Avmed Select Network $880 195%
Amerihealth Caritas Next Exchange $925 205%
Dimension Health Ppo $953 - $1,189 211%
Dimension Health Wc $953 - $1,189 211%
Workers Compensation $953 - $1,189 211%
Beacon Health Strategies Commercial $1,271 - $1,586 282%
Commercial Non-Contracted $1,271 - $1,586 282%
Self Pay - Mcd Pending 100 Percent $1,271 - $1,586 282%
Single Case Agreement $1,271 - $1,586 282%
United Behavioral Health Psych $1,271 - $1,586 282%
Bc/Bs Myblue Hmo Hix $1,786 396%
Bc/Bs Of Fl Simplyblue $1,880 417%
Bc/Bs Of Fl Network Blue $2,005 445%
Bc/Bs Of Fl Health Options Hmo $2,108 468%
Bc/Bs Of Fl Blue Select Exchange Non Par $2,204 489%
Bc/Bs Of Fl Ppo $2,665 591%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals