CMS Price Transparency Data

Blood transfusion

Facility: Ascension St Vincent's Riverside

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $448
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Ascension St Vincent's Riverside is $448. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.99x the Medicare baseline. Located in 1 Shircliff Way, Jacksonville, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$448

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%)

Insurance Median: $448 (99%)

Ins. Median: $448 (99% 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
Humana	$426 - $443	95%
Bc Advantage Mcr Replacement	$439	97%
Blue Cross Blue Shield	$439	97%
Community Hospice	$439	97%
Coventry Mcr Replacement Hmo	$439	97%
Haven Hospice	$439	97%
Heartland Of Hc	$439	97%
Medicare (plans)	$439 - $448	97%
Pace Place	$439	97%
Research Study Encore Borland-Groover	$439	97%
Veterans Administration	$439	97%
Wellcare	$439	97%
Cigna	$443 - $448	98%
UnitedHealthcare	$443	98%
Careplus Mcr Replacement	$448	99%
Aetna	$452 - $900	100%
Bright Health	$592 - $636	131%
Smarthealth	$614	136%
Oscar Health Plan	$702	156%
Employer Direct Healthcare	$768	170%
90 Degree Benefits	$790	175%
Avmed Exchange	$790	175%
Molina Exchange	$812	180%
Occunet	$812 - $987	180%
Ambetter / Centene	$834	185%

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 $X.
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 Ascension St Vincent's Riverside 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.