CMS Price Transparency Data

Blood transfusion

Facility: University of Texas M. D. Anderson Cancer Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,016
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.25x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at University of Texas M. D. Anderson Cancer Center is $1,016. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.25x the Medicare baseline. Located in 1515 Holcombe Blvd, Houston, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,016

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%)

Insurance Median: $1,016 (225%)

Ins. Median: $1,016 (225% 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 225% of the Medicare baseline (a markup of 125%). 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
Texaschildrens	$29 - $630	6%
UnitedHealthcare	$33 - $1,073	7%
Tricare	$36 - $1,073	8%
Blue Cross Blue Shield	$69 - $1,030	15%
Cigna	$72 - $1,073	16%
Aetna	$94 - $1,073	21%
Humana	$211 - $1,102	47%
Ontarioministriesofhealth	$260 - $1,059	58%
Beijingst.Lucia	$263 - $1,073	58%
Embassyofqatar	$263 - $1,073	58%
Memorialhermannhealth	$263 - $1,073	58%
Multiplan	$274 - $1,231	61%
Phcs	$274 - $1,231	61%
Emergingtherapysolutions_Cancercare	$281 - $1,145	62%
Interlink_Cancercare	$281 - $1,145	62%
Saudiarmedforces	$281 - $1,145	62%
Uae_Medical	$281 - $1,145	62%
Uaepoliceattache	$281 - $1,145	62%
Healthsmart	$298 - $1,216	66%
Vantage	$298 - $1,216	66%
Medicare (plans)	$630	140%
Vacare	$630 - $717	140%
Emergingtherapysolutions	$1,073 - $1,145	238%
Interlink	$1,073 - $1,216	238%

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 $X.
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 University of Texas M. D. Anderson Cancer 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.