CMS Price Transparency Data

Blood transfusion

Facility: Palm Beach Gardens Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,458
Cash Discount Price: $1,642
vs. Medicare Baseline: 3.23x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Palm Beach Gardens Medical Center is $1,458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,642. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.23x the Medicare baseline. Located in 3360 Burns Rd, Palm Beach Gardens, FL.

Cash / Self-Pay

$1,642

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,458

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: $1,642 (364%)

Insurance Median: $1,458 (323%)

Cash: $1,642 (364% of Medicare)

Ins. Median: $1,458 (323% 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 323% of the Medicare baseline (a markup of 223%). 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
Humana	$51 - $3,024	11%
Ambetter / Centene	$53 - $66	12%
Oscar Health Plan	$75	17%
Molina	$106	24%
Aetna	$350 - $2,259	78%
UnitedHealthcare	$1,134 - $1,757	252%
Cigna	$1,292 - $3,956	287%
Blue Cross Blue Shield	$1,735 - $2,516	385%

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 $1,642.
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 Palm Beach Gardens Medical Center 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.