CMS Price Transparency Data

Blood transfusion

Facility: Coral Gables Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $430
  • Cash Discount Price: $1,271
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Coral Gables Hospital is $430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,271. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.95x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
$1,271

Average discount available for prompt cash payment at this facility.

Insurance Median
$430

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: $1,271 (282%)
Insurance Median: $430 (95%)
Cash: $1,271 (282% of Medicare)
Ins. Median: $430 (95% 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.

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
Aetna $38 - $953 8%
Healthsun Health Plans $46 - $444 10%
Self Pay/Uninsured $54 - $529 12%
Employer Direct Healthcare $55 - $430 12%
Oscar Health Plan Hix $123 27%
Imagine Health $127 28%
Cigna $221 - $444 49%
UnitedHealthcare $264 - $423 59%
Humana $279 - $464 62%
Medicaid / KanCare $279 - $293 62%
Veterans Administration Mill Bill $296 66%
Avmed Broad Network $311 69%
Medicare (plans) $381 - $925 85%
Leon Health Inc $421 93%
Devoted Health $423 94%
Tricare $426 95%
Catholic Hospice $430 95%
Hcr Manor Care Services Of Fl Ii Dba Heartland Hospice Services $430 95%
Hospice Other $430 95%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $430 95%
Opus Care Of South Florida $430 95%
Seasons Hospice And Palliative Care Of Southern Florida Inc $430 95%
Veterans Administration Vaccn $430 95%
Vitas Healthcare Corporation/Hospice Ppo $430 95%
Longevity Health Plan $449 100%
Florida Pace Centers $508 113%
Bright Health Management Commercial $516 114%
Naphcare Inc $592 131%
Bc/Bs Of Fl Phs $683 152%
Avmed Exchange $753 167%
Ambetter / Centene $796 177%
Molina Marketplace Program Exchange $819 182%
Dimension International $826 183%
Auto Insurance $860 191%
Avmed Select Network $880 195%
First Health $903 200%
Amerihealth Caritas Next Exchange $925 205%
Dimension Health Ppo $953 211%
Dimension Health Wc $953 211%
Workers Compensation $953 211%
Commercial Non-Contracted $1,271 282%
Self Pay - Mcd Pending 100 Percent $1,271 282%
Single Case Agreement $1,271 282%
Bc/Bs Of Fl Miami Dade Blue Select $1,617 359%
Bc/Bs Myblue Hmo Hix $1,692 375%
Bc/Bs Of Fl Simplyblue $1,781 395%
Bc/Bs Of Fl Health Options Hmo $2,000 444%
Bc/Bs Of Fl Network Blue $2,051 455%
Bc/Bs Of Fl Blue Select Exchange Non Par $2,254 500%
Bc/Bs Of Fl Ppo $2,630 583%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Douglas Rd, Coral Gables, FL 33134
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals