CMS Price Transparency Data

Blood transfusion

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $525
  • Cash Discount Price: $897
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Physicians Regional Medical Center - Pine Ridge is $525. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $897. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.16x the Medicare baseline. Located in 6101 Pine Ridge Road, Naples, FL.
Cash / Self-Pay
$897

Average discount available for prompt cash payment at this facility.

Insurance Median
$525

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: $897 (199%)
Insurance Median: $525 (116%)
Cash: $897 (199% of Medicare)
Ins. Median: $525 (116% 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.

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
Veterans Eval Services $40 9%
Childrens Medical Services $290 64%
Medicaid / KanCare $290 - $319 64%
UnitedHealthcare $290 - $965 64%
Humana $299 - $453 66%
Integral Health $304 67%
Wellcare $304 67%
Simply Healthcare Plan $307 68%
Magellan $312 69%
Amerigroup $316 70%
Prestige Health $336 75%
Tricare $438 97%
Aetna $453 - $2,648 101%
Blue Cross Blue Shield $453 - $8,086 101%
Medicare (plans) $453 101%
Node Champva $461 102%
Node Non Par Hospice Agree $461 102%
Node Va $461 102%
Freedom Optimum $467 104%
Node Wellcare Mcr Adv $475 105%
Node Us Dept Of Labor $576 128%
Self Pay $718 - $957 159%
Florida State Auto Insurance $921 204%
Occunet $1,152 - $2,375 256%
Ambetter / Centene $1,175 261%
Simply Healthcare $1,236 274%
Avmed $1,515 336%
Cigna $1,611 357%
Community Health Partners $2,373 526%
Prime Health Work Comp Fl $2,560 568%
Rockport $2,560 568%
Florida Workers Compensation $2,639 585%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6101 Pine Ridge Road, Naples, FL 34119
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals