CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Northside Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $424
Cash Discount Price: $1,618
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Northside Hospital is $424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,618. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.94x the Medicare baseline. Located in 6000 49Th St N, Saint Petersburg, FL.

Cash / Self-Pay

$1,618

Average discount available for prompt cash payment at this facility.

Insurance Median

$424

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: $1,618 (359%)

Insurance Median: $424 (94%)

Cash: $1,618 (359% of Medicare)

Ins. Median: $424 (94% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$59 - $1,638	13%
Access 2 Healthcare Physicians Freedom Health	$91 - $1,950	20%
Access 2 Healthcare Physicians Optimum	$91 - $1,950	20%
Freedom Health Care	$98 - $1,950	22%
Optimum Healthcare	$98 - $1,950	22%
Avmed	$101 - $570	22%
Suncoast Neighborly Care	$101 - $2,400	22%
Simply Healthcare	$160 - $2,250	35%
Oscar	$189 - $2,660	42%
Aetna	$201 - $684	45%
United	$207 - $2,564	46%
Cigna	$227 - $7,480	50%
Evolutions Healthcare Systems	$290 - $2,098	64%
Sunshine State Health Plan	$322 - $581	71%
Humana	$353 - $638	78%
Corvel Corporation	$449 - $2,572	100%
Rockport Healthcare Group	$449 - $2,572	100%
Prime Health	$459 - $2,626	102%
Plotkin Health	$631 - $1,140	140%
Prime Health Sheriff	$631 - $1,140	140%
Multiplan	$946 - $1,938	210%
Blue Cross Blue Shield	$1,715 - $5,228	380%
Truli	$1,715 - $2,160	380%
Molina	$1,950 - $2,702	433%

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 $1,618.
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 Northside 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.