CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Oak Hill Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,638
Cash Discount Price: $3,162
vs. Medicare Baseline: 3.63x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Oak Hill Hospital is $1,638. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,162. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.63x the Medicare baseline. Located in 11375 Cortez Blvd, Brooksville, FL.

Cash / Self-Pay

$3,162

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,638

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: $3,162 (702%)

Insurance Median: $1,638 (363%)

Cash: $3,162 (702% of Medicare)

Ins. Median: $1,638 (363% 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 363% of the Medicare baseline (a markup of 263%). 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$149 - $1,638	33%
Access 2 Healthcare Physicians Freedom Health	$228 - $1,950	51%
Access 2 Healthcare Physicians Optimum	$228 - $1,950	51%
Freedom Health Care	$247 - $1,950	55%
Optimum Healthcare	$247 - $1,950	55%
Avmed	$253 - $791	56%
Simply Healthcare	$402 - $2,250	89%
Aetna	$414 - $949	92%
Corvel Corporation	$449 - $2,572	100%
Rockport Healthcare Group	$449 - $2,572	100%
Prime Health	$459 - $2,626	102%
Oscar	$474 - $2,660	105%
United	$519 - $2,564	115%
Cigna	$550 - $8,484	122%
Evolutions Healthcare Systems	$727 - $2,909	161%
Sunshine State Health Plan	$806	179%
Humana	$885	196%
Plotkin Health	$1,581	351%
Prime Health Sheriff	$1,581	351%
Blue Cross Blue Shield	$1,696 - $5,207	376%
Truli	$1,696 - $2,147	376%
Molina	$1,950 - $2,702	433%
Multiplan	$2,372 - $2,688	526%

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 $3,162.
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 Oak Hill 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.