CMS Price Transparency Data

Blood transfusion

Facility: West Kendall Baptist Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $516
  • Cash Discount Price: $851
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at West Kendall Baptist Hospital is $516. 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 1.14x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$851

Average discount available for prompt cash payment at this facility.

Insurance Median
$516

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: $516 (114%)
Cash: $851 (189% of Medicare)
Ins. Median: $516 (114% 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%
Avmed $203 - $637 45%
Cigna $210 - $1,047 47%
Amerigroup $267 59%
Medicaid / KanCare $267 - $294 59%
UnitedHealthcare $280 - $1,309 62%
Wellcare $280 62%
Sunshine State $283 63%
Aetna $288 - $1,047 64%
Vista $288 64%
Medicare (plans) $461 - $622 102%
Non Contracted $480 106%
Medica Health Plan $493 109%
Humana $502 111%
Leon Medical $516 114%
Amerihealth $589 131%
International $851 189%
Dimension Health Plan $982 - $1,178 218%
Affordable $1,178 261%
Phcs $1,178 261%
Quality Health $1,178 261%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals