CMS Price Transparency Data
Blood transfusion
Facility: Palmetto General Hospital
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $444
- Cash Discount Price: $1,271
- vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Palmetto General Hospital is $444. 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 0.99x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$1,271
Average discount available for prompt cash payment at this facility.
Insurance Median
$444
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: $444 (99%)
Cash: $1,271 (282% of Medicare)
Ins. Median: $444 (99% 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.
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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 - $906 | 8% |
| Healthsun Health Plans | $46 - $444 | 10% |
| Self Pay/Uninsured | $54 - $529 | 12% |
| Employer Direct Healthcare | $55 - $430 | 12% |
| Oscar Health Plan Hix | $78 | 17% |
| Imagine Health | $127 | 28% |
| Cigna | $221 - $636 | 49% |
| Humana | $279 - $516 | 62% |
| Medicaid / KanCare | $279 - $1,271 | 62% |
| UnitedHealthcare | $283 - $456 | 63% |
| Veterans Administration Mill Bill | $296 | 66% |
| Avmed Broad Network | $345 | 77% |
| Medicare (plans) | $381 - $1,271 | 85% |
| Leon Health Inc | $421 | 93% |
| Devoted Health | $423 | 94% |
| Tricare | $426 | 95% |
| Bristol Hospice- Miami Dade Llc | $430 | 95% |
| Catholic Hospice | $430 | 95% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $430 | 95% |
| Hospice Other | $430 | 95% |
| Ima Evalutations Inc | $430 | 95% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $430 | 95% |
| Opuscare Of South Fl | $430 | 95% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $430 | 95% |
| Select Specialty Hospital | $430 | 95% |
| Veterans Administration Vaccn | $430 | 95% |
| Vitas Healthcare Hospice | $430 | 95% |
| Westchester General Hospital | $430 | 95% |
| Longevity Health Plan | $452 | 100% |
| Florida Pace Centers | $508 | 113% |
| Bright Health Management Commercial | $516 | 114% |
| Naphcare Inc | $592 | 131% |
| Liga Contra El Cancer | $636 | 141% |
| Bc/Bs Of Fl Phs | $638 | 142% |
| Avmed Exchange | $753 | 167% |
| Magellan Behavioral Health | $763 | 169% |
| Ambetter / Centene | $796 | 177% |
| Molina Marketplace Program Exchange | $819 | 182% |
| Dimensions International | $826 | 183% |
| First Health | $852 | 189% |
| Auto Insurance | $860 | 191% |
| Avmed Select Network | $880 | 195% |
| Amerihealth Caritas Next Exchange | $925 | 205% |
| Dimension Health Ppo | $953 | 211% |
| Dimension Health Wc | $953 | 211% |
| Workers Compensation | $953 | 211% |
| Beacon Health Strategies Commercial | $1,271 | 282% |
| Commercial Non-Contracted | $1,271 | 282% |
| Self Pay - Mcd Pending 100 Percent | $1,271 | 282% |
| Single Case Agreement | $1,271 | 282% |
| United Behavioral Health Psych | $1,271 | 282% |
| Bc/Bs Of Fl Miami Dade Blue Select | $1,662 | 369% |
| Bc/Bs Myblue Hmo Hix | $1,722 | 382% |
| Bc/Bs Of Fl Simplyblue | $1,812 | 402% |
| Bc/Bs Of Fl Network Blue | $1,974 | 438% |
| Bc/Bs Of Fl Health Options Hmo | $2,036 | 452% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $2,170 | 481% |
| Bc/Bs Of Fl Ppo | $2,677 | 594% |