CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida West Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $938
Cash Discount Price: $2,084
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida West Hospital is $938. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,084. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.08x the Medicare baseline. Located in 8383 N Davis Hwy, Pensacola, FL.

Cash / Self-Pay

$2,084

Average discount available for prompt cash payment at this facility.

Insurance Median

$938

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: $2,084 (462%)

Insurance Median: $938 (208%)

Cash: $2,084 (462% of Medicare)

Ins. Median: $938 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Oscar	$229 - $2,138	51%
Freedom Health	$265 - $267	59%
Aetna	$317 - $631	70%
Simply	$321 - $2,250	71%
Simply Healthcare	$348 - $1,735	77%
Cigna	$362 - $40,673	80%
Humana	$417 - $421	93%
Corvel Corporation	$425 - $2,436	94%
Prime Health	$434 - $2,487	96%
Careworks (Rockport Community)	$448 - $2,564	99%
United	$448 - $2,332	99%
Avmed	$500 - $1,052	111%
Sunshine State Health Plan	$531 - $536	118%
Molina Healthcare	$667 - $3,950	148%
Pensacola Christian	$833 - $841	185%
Plotkin Health	$1,042 - $1,052	231%
Prime Health Sheriff	$1,042 - $1,052	231%
Evolutions Healthcare	$1,354 - $1,788	300%
Multiplan	$1,625 - $1,788	361%
Evernorth	$1,666 - $1,683	370%
Ppo Next	$1,771 - $1,788	393%
Novanet	$1,875 - $1,893	416%
Blue Cross Blue Shield	$2,040 - $3,371	453%
Beacon Health Options	$2,083 - $2,104	462%
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 $2,084.
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 West 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.