CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Capital Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,271
Cash Discount Price: $3,081
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Capital Hospital is $1,271. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,081. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.82x the Medicare baseline. Located in 2626 Capital Medical Blvd, Tallahassee, FL.

Cash / Self-Pay

$3,081

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,271

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: $3,081 (684%)

Insurance Median: $1,271 (282%)

Cash: $3,081 (684% of Medicare)

Ins. Median: $1,271 (282% 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 282% of the Medicare baseline (a markup of 182%). 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	$291 - $2,516	65%
Aetna	$340 - $1,117	75%
Simply	$345 - $2,250	77%
Simply Healthcare	$374 - $1,735	83%
Cigna	$389 - $40,673	86%
Corvel Corporation	$412 - $2,357	91%
Prime Health	$420 - $2,407	93%
Careworks (Rockport Community)	$433 - $2,481	96%
Humana	$448 - $745	99%
United	$454 - $3,668	101%
Avmed	$537 - $1,862	119%
Sunshine State Health Plan	$571 - $950	127%
Molina Healthcare	$716 - $3,950	159%
Plotkin Health	$1,119 - $1,862	248%
Prime Health Sheriff	$1,119 - $1,862	248%
Multiplan	$1,746 - $3,165	387%
Evernorth	$1,791 - $2,979	397%
Evolutions Healthcare	$1,902 - $3,165	422%
Ppo Next	$1,902 - $3,165	422%
Blue Cross Blue Shield	$1,998 - $2,687	443%
Novanet	$2,014 - $3,351	447%
Beacon Health Options	$2,238 - $3,724	497%
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 $3,081.
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 Capital 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.