CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Orange Park Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $447
Cash Discount Price: $1,118
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Orange Park Hospital is $447. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,118. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.99x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$1,118

Average discount available for prompt cash payment at this facility.

Insurance Median

$447

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: $1,118 (248%)

Insurance Median: $447 (99%)

Cash: $1,118 (248% of Medicare)

Ins. Median: $447 (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.

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
Optimum Healthcare	$89 - $1,950	20%
Blue Cross Blue Shield	$113 - $3,083	25%
Avmed	$128 - $328	28%
United	$128 - $3,016	28%
Simply Healthcare	$135 - $2,250	30%
Oscar	$170 - $2,284	38%
Aetna	$183 - $352	41%
Positive Healthcare	$234 - $2,450	52%
Cigna	$254 - $14,306	56%
Sunshine State Health Plan	$271 - $299	60%
Molina Healthcare	$287 - $2,702	64%
Humana	$436 - $481	97%
Corvel Corporation	$443 - $2,534	98%
Prime Health	$452 - $2,587	100%
Medicare (plans)	$479 - $2,340	106%
Plotkin Health	$532 - $586	118%
Multiplan	$830 - $996	184%
Evernorth	$852 - $938	189%
Evolutions Healthcare	$852 - $996	189%
Ppo Next	$905 - $996	201%
Novanet	$958 - $1,055	213%

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 $1,118.
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 Orange Park 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.