CMS Price Transparency Data

Blood transfusion

Facility: Wellington Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,826
Cash Discount Price: $2,279
vs. Medicare Baseline: 6.27x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Wellington Regional Medical Center is $2,826. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,279. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 6.27x the Medicare baseline. Located in 10101 Forest Hill Blvd, Wellington, FL.

Cash / Self-Pay

$2,279

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,826

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: $2,279 (506%)

Insurance Median: $2,826 (627%)

Cash: $2,279 (506% of Medicare)

Ins. Median: $2,826 (627% 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 627% of the Medicare baseline (a markup of 527%). 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
United_Healthcare	$957	212%
Humana	$972	216%
Multiplan	$1,915	425%
Cigna	$2,492 - $2,826	553%
Aetna	$2,516 - $2,982	558%
Av_Med	$2,522	560%
Blue_Cross_Blue_Shield_Of_Fl	$4,534 - $6,361	1006%

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 $2,279.
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 Wellington Regional Medical Center 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.