CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Osceola Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,375
Cash Discount Price: $1,718
vs. Medicare Baseline: 3.05x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Osceola Hospital is $1,375. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,718. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.05x the Medicare baseline. Located in 700 West Oak Street, Kissimmee, FL.

Cash / Self-Pay

$1,718

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,375

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: $1,718 (381%)

Insurance Median: $1,375 (305%)

Cash: $1,718 (381% of Medicare)

Ins. Median: $1,375 (305% 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 305% of the Medicare baseline (a markup of 205%). 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
Freedom Health	$124 - $1,950	28%
Optimum	$124 - $1,950	28%
Avmed	$137 - $859	30%
Simply	$265 - $2,250	59%
Oscar	$275 - $1,997	61%
Simply Healthcare	$287 - $1,735	64%
Cigna	$299 - $7,321	66%
Aetna	$340 - $516	75%
Sunshine State Health Plan	$438	97%
Corvel Corporation	$443 - $2,538	98%
Prime Health	$453 - $2,591	101%
Molina Healthcare	$464 - $3,950	103%
Careworks (Rockport Community)	$467 - $2,671	104%
Humana	$481	107%
United	$574 - $2,264	127%
Plotkin Health	$859	191%
Prime Health Sheriff	$859	191%
Multiplan	$1,289 - $1,461	286%
Evernorth	$1,375	305%
Ppo Next	$1,461	324%
Novanet	$1,547	343%
Beacon Health Options	$1,718	381%
Truli For Health	$1,723	382%
Blue Cross Blue Shield	$1,826 - $4,876	405%
Evolutions	$4,121	914%
Ultimate Health Plan	$12,500	2773%

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 $1,718.
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 HCA Florida Osceola 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.