CMS Price Transparency Data

Blood transfusion

Facility: Doctors Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $511
  • Cash Discount Price: $851
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Doctors Hospital is $511. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $851. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.13x the Medicare baseline. Located in 5000 University Dr, Coral Gables, FL.
Cash / Self-Pay
$851

Average discount available for prompt cash payment at this facility.

Insurance Median
$511

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: $851 (189%)
Insurance Median: $511 (113%)
Cash: $851 (189% of Medicare)
Ins. Median: $511 (113% 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
Blue Cross Blue Shield $191 - $848 42%
Humana $201 - $502 45%
Avmed $203 - $648 45%
Aetna $205 - $1,047 45%
Leon Medical $206 - $516 46%
Cigna $210 - $1,047 47%
Medicare (plans) $238 - $622 53%
Amerigroup $267 59%
Medicaid / KanCare $267 - $294 59%
UnitedHealthcare $280 - $1,309 62%
Wellcare $280 62%
Sunshine State $283 63%
Vista $288 64%
Non Contracted $480 106%
Medica Health Plan $493 109%
Amerihealth $589 131%
International $851 189%
Dimension Health Plan $982 - $1,178 218%
Affordable $1,113 247%
Phcs $1,178 261%
Quality Health $1,178 261%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5000 University Dr, Coral Gables, FL 33146
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals