CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Northwest Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,314
Cash Discount Price: $2,628
vs. Medicare Baseline: 2.92x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Northwest Hospital is $1,314. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,628. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.92x the Medicare baseline. Located in 2801 N State Rd 7, Margate, FL.

Cash / Self-Pay

$2,628

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,314

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: $2,628 (583%)

Insurance Median: $1,314 (292%)

Cash: $2,628 (583% of Medicare)

Ins. Median: $1,314 (292% 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 292% of the Medicare baseline (a markup of 192%). 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	$226 - $2,350	50%
Optimum	$226 - $2,350	50%
Avmed	$342 - $1,314	76%
Simply Healthcare Plans	$342 - $2,160	76%
Simply Healthcare	$355 - $1,423	79%
Aetna	$365 - $788	81%
Oscar	$420 - $1,575	93%
Amerihealth Caritas	$447 - $3,251	99%
Corvel Corporation	$487 - $2,786	108%
Careworks (Rockport)	$497 - $2,844	110%
Prime Health	$497 - $2,844	110%
Cigna	$552 - $6,802	122%
Humana	$552 - $894	122%
Health Sun Health Plan	$560 - $2,050	124%
United Ppo	$623	138%
Sunshine State Health Plan	$694	154%
Molina	$710 - $2,702	158%
Blis	$920	204%
United	$1,183 - $2,020	262%
Plotkin Health	$1,314	292%
Prime Health Sherriff	$1,314	292%
Medica Healthcare	$1,524 - $2,750	338%
Multiplan	$1,971 - $2,234	437%
Blue Cross Blue Shield	$2,142 - $3,942	475%
Mmm Of Fl (Health Advantage Plan)	$2,250	499%

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 $2,628.
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 Northwest 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.