CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Lake City Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $826
Cash Discount Price: $1,530
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Lake City Hospital is $826. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,530. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.83x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.

Cash / Self-Pay

$1,530

Average discount available for prompt cash payment at this facility.

Insurance Median

$826

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: $1,530 (339%)

Insurance Median: $826 (183%)

Cash: $1,530 (339% of Medicare)

Ins. Median: $826 (183% 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
Avmed	$184 - $765	41%
Oscar	$184 - $2,264	41%
Simply Healthcare	$194 - $1,394	43%
Aetna	$223 - $459	49%
Simply	$236 - $2,250	52%
Cigna	$266 - $35,535	59%
Humana	$306	68%
United	$361 - $5,107	80%
Sunshine State Health Plan	$390	87%
Corvel Corporation	$417 - $2,384	93%
Prime Health	$425 - $2,435	94%
Careworks (Rockport Community)	$438 - $2,510	97%
Molina Healthcare	$490 - $3,242	109%
Plotkin Health	$765	170%
Prime Health Sheriff	$765	170%
Hamilton County Jail	$826	183%
Multiplan	$1,193 - $1,300	265%
Evolutions	$1,300 - $4,121	288%
Ppo Next	$1,300	288%
Novanet	$1,377	306%
Blue Cross Blue Shield	$2,051 - $3,220	455%
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 $1,530.
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 Lake City 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.