CMS Price Transparency Data

Blood transfusion

Facility: University of Miami Hospital and Clinics

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,604
Cash Discount Price: $722
vs. Medicare Baseline: 3.56x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at University of Miami Hospital and Clinics is $1,604. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $722. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.56x the Medicare baseline. Located in 1475 Nw 12Th Ave Suite 2175, Miami, FL.

Cash / Self-Pay

$722

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,604

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: $722 (160%)

Insurance Median: $1,604 (356%)

Cash: $722 (160% of Medicare)

Ins. Median: $1,604 (356% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 356% of the Medicare baseline (a markup of 256%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$451 - $1,380	100%
Aetna	$487 - $1,468	108%
Solis Health	$496	110%
Humana	$512	114%
Careplus	$668	148%
Sunshine Health	$668	148%
Molina Healthcare Of Fl	$722	160%
Amerihealth Caritas Fl	$749	166%
Oscar Health Of Fl	$749	166%
Cigna	$965 - $1,163	214%
Curative	$1,417	314%
Employers Health Network	$1,604	356%
Simply Healthcare	$1,604	356%
First Health	$1,738	386%
Health First New York Health Insurance	$1,738	386%
Broward Health	$1,872	415%
Beech Street	$2,139	475%
Dimension Health	$2,139	475%
Multiplan	$2,139	475%
Blue Cross Blue Shield	$3,082 - $5,511	684%

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 $722.
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 University of Miami Hospital and Clinics 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.