CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Palms West Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $993
  • Cash Discount Price: $2,090
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Palms West Hospital is $993. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,090. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.20x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.
Cash / Self-Pay
$2,090

Average discount available for prompt cash payment at this facility.

Insurance Median
$993

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: $2,090 (464%)
Insurance Median: $993 (220%)
Cash: $2,090 (464% of Medicare)
Ins. Median: $993 (220% 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 220% of the Medicare baseline (a markup of 120%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $180 - $2,350 40%
Optimum $180 - $2,350 40%
Avmed $272 - $1,045 60%
Simply Healthcare Plans $272 - $2,160 60%
Simply Healthcare $282 - $1,423 63%
Aetna $326 - $627 72%
Oscar $334 - $1,575 74%
Amerihealth Caritas $355 - $3,057 79%
Cigna $439 - $6,802 97%
Humana $439 - $711 97%
Health Sun Health Plan $445 - $2,050 99%
Aids Healthcare $460 - $2,508 102%
Corvel Corporation $465 - $2,660 103%
Careworks (Rockport) $475 - $2,716 105%
Prime Health $475 - $2,716 105%
United Ppo $495 110%
Sunshine State Health Plan $543 120%
Healthy Palm Beaches $550 122%
Molina $564 - $2,702 125%
United $940 - $2,020 209%
Health Care District $1,045 232%
Palm Beach Juvenile Correction $1,045 232%
Plotkin Health $1,045 232%
Prime Health Sherriff $1,045 232%
Medica Healthcare $1,212 - $2,750 269%
Multiplan $1,568 - $1,776 348%
Blue Cross Blue Shield $2,142 - $3,942 475%
Mmm Of Fl (Health Advantage Plan) $2,250 499%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13001 Southern Blvd, Loxahatchee, FL 33470
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals