CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida North Florida Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $576
Cash Discount Price: $1,352
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida North Florida Hospital is $576. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,352. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$1,352

Average discount available for prompt cash payment at this facility.

Insurance Median

$576

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: $1,352 (300%)

Insurance Median: $576 (128%)

Cash: $1,352 (300% of Medicare)

Ins. Median: $576 (128% 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	$92 - $1,343	20%
Oscar	$92 - $2,264	20%
Simply Healthcare	$97 - $1,394	22%
Aetna	$112 - $806	25%
United	$115 - $5,259	26%
Simply	$118 - $2,250	26%
Cigna	$133 - $35,535	30%
Humana	$153 - $537	34%
Sunshine State Health Plan	$196 - $685	43%
Molina Healthcare	$245 - $3,950	54%
Plotkin Health	$384 - $1,343	85%
Prime Health Sheriff	$384 - $1,343	85%
Corizon Phs	$460 - $1,611	102%
Corvel Corporation	$468 - $2,677	104%
Prime Health	$477 - $2,733	106%
Careworks (Rockport Community)	$492 - $2,818	109%
Multiplan	$598 - $2,283	133%
Evernorth	$614 - $2,148	136%
Evolutions Healthcare	$652 - $2,283	145%
Ppo Next	$652 - $2,283	145%
Novanet	$690 - $2,417	153%
Beacon Health Options	$767 - $2,686	170%
Blue Cross Blue Shield	$2,008 - $2,922	445%
Capital Health Plan	$2,531 - $3,041	562%
Evolutions	$4,121	914%
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 $1,352.
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 North Florida 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.