CMS Price Transparency Data

Blood transfusion

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $818
Cash Discount Price: $1,498
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Cleveland Clinic Indian River Hospital is $818. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,498. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.81x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$1,498

Average discount available for prompt cash payment at this facility.

Insurance Median

$818

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: $1,498 (332%)

Insurance Median: $818 (181%)

Cash: $1,498 (332% of Medicare)

Ins. Median: $818 (181% 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
Blue Cross Blue Shield	$31 - $3,873	7%
UnitedHealthcare	$31	7%
Amerihealth	$33	7%
Medicaid / KanCare	$33	7%
Molina	$33	7%
Value Options	$33 - $42	7%
Wellcare	$33 - $439	7%
Aetna	$42 - $2,893	9%
Avmed	$42 - $1,005	9%
Careplus	$42 - $439	9%
Cigna	$42 - $1,085	9%
Magellan	$42 - $2,170	9%
United	$42 - $756	9%
Freedom Health	$45 - $439	10%
Independent Living Systems	$45 - $461	10%
Wellmed	$45 - $439	10%
Clear Spring Health	$46 - $64	10%
Carelon Bh Strategies	$439	97%
Humana	$439	97%
Devoted Health	$483	107%
Bmi	$521 - $1,989	116%
Clarity Health	$616 - $2,350	137%
The Legacy Companies	$616 - $2,350	137%
National Provider Network	$685	152%
Three Rivers	$685	152%
Consociate Health	$734	163%
Multiplan	$758 - $2,893	168%

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 $1,498.
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 Cleveland Clinic Indian River Hospital 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.