CMS Price Transparency Data

Blood transfusion

Facility: Hialeah Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $444
  • Cash Discount Price: $1,770
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Hialeah Hospital is $444. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,770. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.99x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$1,770

Average discount available for prompt cash payment at this facility.

Insurance Median
$444

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: $1,770 (393%)
Insurance Median: $444 (99%)
Cash: $1,770 (393% of Medicare)
Ins. Median: $444 (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.

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
Healthsun Health Plans $46 - $444 10%
Aetna $53 - $1,275 12%
Self Pay/Uninsured $54 - $529 12%
Employer Direct Healthcare $55 - $430 12%
Oscar Health Plan Hix $109 24%
Imagine Health $177 39%
Humana $279 - $811 62%
Medicaid / KanCare $279 - $293 62%
UnitedHealthcare $283 - $602 63%
Veterans Administration Mill Bill $296 66%
Cigna $308 - $520 68%
Avmed Broad Network $372 83%
Medicare (plans) $381 - $925 85%
Leon Health Inc $421 93%
Devoted Health $423 94%
Tricare $426 95%
Bristol Hospice- Miami Dade Llc $430 95%
Catholic Hospice $430 95%
Comprehensive Home Health Care Dba Opuscare Of South Florida $430 95%
Hcr Manor Care Services Of Fl $430 95%
Hospice Other $430 95%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $430 95%
Seasons Hospice And Pallative Care Of Southern Florida Inc $430 95%
Veterans Administration Vaccn $430 95%
Vitas Healthcare Hospice Corporation Of Fl $430 95%
Vitas Hospice Unit Agreement $430 95%
Longevity Health Plan $449 100%
Florida Pace Centers $508 113%
Bright Health Management Commercial $516 114%
Naphcare Inc $592 131%
Avmed Exchange $753 167%
Ambetter / Centene $796 177%
Molina Marketplace Program Exchange $819 182%
Auto Insurance $860 191%
Avmed Select Network $880 195%
Bc/Bs Of Fl Phs $918 204%
Amerihealth Caritas Next Exchange $925 205%
Dimensions International $1,151 255%
First Health $1,204 267%
Dimension Health Ppo $1,328 295%
Dimension Health Wc $1,328 295%
Workers Compensation $1,328 295%
Bc/Bs Of Fl Miami Dade Blue Select $1,521 337%
Bc/Bs Myblue Hmo Hix $1,585 352%
Bc/Bs Of Fl Simplyblue $1,668 370%
Commercial Non-Contracted $1,770 393%
Self Pay - Mcd Pending 100 Percent $1,770 393%
Single Case Agreement $1,770 393%
Bc/Bs Of Fl Health Options Hmo $1,877 416%
Bc/Bs Of Fl Network Blue $1,945 432%
Bc/Bs Of Fl Blue Select Exchange Non Par $2,138 474%
Bc/Bs Of Fl Ppo $2,686 596%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals