CMS Price Transparency Data

Blood transfusion

Facility: Marion Communtiy Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $863
  • Cash Discount Price: $2,252
  • vs. Medicare Baseline: 1.91x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Marion Communtiy Hospital is $863. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,252. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.91x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$2,252

Average discount available for prompt cash payment at this facility.

Insurance Median
$863

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: $2,252 (500%)
Insurance Median: $863 (191%)
Cash: $2,252 (500% of Medicare)
Ins. Median: $863 (191% 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
Avmed $263 - $755 58%
Simply Healthcare $278 - $1,394 62%
Aetna $320 - $809 71%
Simply $337 - $2,250 75%
Cigna $381 - $35,535 85%
United $381 - $3,495 85%
Corvel Corporation $422 - $2,417 94%
Prime Health $431 - $2,468 96%
Humana $438 - $540 97%
Careworks (Rockport Community) $444 - $2,544 99%
Marion County Schools $444 - $2,544 99%
Evolutions Healthcare $504 - $620 112%
Sunshine State Health Plan $559 - $688 124%
Molina Healthcare $701 - $3,950 156%
Plotkin Health $1,095 - $1,349 243%
Prime Health Sheriff $1,095 - $1,349 243%
Multiplan $1,709 - $2,104 379%
Ppo Next $1,862 - $2,293 413%
Novanet $1,971 - $2,428 437%
Blue Cross Blue Shield $2,008 - $2,922 445%
Evolutions $4,121 914%
Ultimate Health Plan $12,500 2773%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals