CMS Price Transparency Data

Blood transfusion

Facility: HCA Florida Poinciana Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $589
Cash Discount Price: $1,923
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Florida Poinciana Hospital is $589. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,923. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.31x the Medicare baseline. Located in 325 Cypress Pkwy, Kissimmee, FL.

Cash / Self-Pay

$1,923

Average discount available for prompt cash payment at this facility.

Insurance Median

$589

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: $1,923 (427%)

Insurance Median: $589 (131%)

Cash: $1,923 (427% of Medicare)

Ins. Median: $589 (131% 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.

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
Freedom Health	$114 - $1,950	25%
Optimum	$114 - $1,950	25%
Avmed	$127 - $1,077	28%
Simply	$244 - $2,250	54%
Oscar	$253 - $1,997	56%
Simply Healthcare	$264 - $1,735	59%
Cigna	$276 - $7,321	61%
Aetna	$314 - $646	70%
Sunshine State Health Plan	$404 - $549	90%
Molina Healthcare	$428 - $3,950	95%
Corvel Corporation	$443 - $2,538	98%
Humana	$443 - $603	98%
Prime Health	$453 - $2,591	101%
Careworks (Rockport Community)	$467 - $2,671	104%
United	$519 - $2,234	115%
Plotkin Health	$792 - $1,077	176%
Prime Health Sheriff	$792 - $1,077	176%
Multiplan	$1,188 - $1,831	264%
Truli For Health	$1,723	382%
Blue Cross Blue Shield	$1,826 - $4,876	405%
Evolutions	$4,121	914%
Ultimate Health Plan	$12,500	2773%

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 $1,923.
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 HCA Florida Poinciana Hospital 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.