CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Raulerson Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $640
Cash Discount Price: $2,036
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Raulerson Hospital is $640. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,036. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.42x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.

Cash / Self-Pay

$2,036

Average discount available for prompt cash payment at this facility.

Insurance Median

$640

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: $2,036 (452%)

Insurance Median: $640 (142%)

Cash: $2,036 (452% of Medicare)

Ins. Median: $640 (142% 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
Freedom Health	$155 - $2,350	34%
Optimum	$155 - $2,350	34%
Avmed	$234 - $1,232	52%
Simply Healthcare Plans	$234 - $2,160	52%
Aetna	$313 - $739	69%
Oscar	$342 - $3,587	76%
Health Sun Health Plan	$383 - $2,050	85%
Corvel Corporation	$417 - $2,384	93%
Simply Healthcare	$423 - $2,518	94%
Careworks (Rockport)	$425 - $2,435	94%
Prime Health	$425 - $2,435	94%
Sunshine State Health Plan	$459 - $628	102%
Cigna	$473 - $15,153	105%
Molina	$486 - $2,702	108%
Humana	$666 - $985	148%
United Ppo	$792 - $1,084	176%
United	$810 - $7,600	180%
Plotkin Health	$900 - $1,232	200%
Prime Health Sherriff	$900 - $1,232	200%
Multiplan	$1,349 - $2,094	299%
Blue Cross Blue Shield	$3,945 - $7,531	875%

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 $2,036.
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 Raulerson 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.