CMS Price Transparency Data

Blood transfusion

Facility: Medical Center Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $493
Cash Discount Price: $760
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Medical Center Hospital is $493. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $760. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.09x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$760

Average discount available for prompt cash payment at this facility.

Insurance Median

$493

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: $760 (169%)

Insurance Median: $493 (109%)

Cash: $760 (169% of Medicare)

Ins. Median: $493 (109% 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
Ambetter / Centene	$29 - $458	6%
Amerigroup	$29	6%
Blue Cross Blue Shield	$29 - $510	6%
Community Health Choice	$29	6%
First Care Health Plan	$29	6%
Superior Health Plan	$29	6%
UnitedHealthcare	$29 - $813	6%
Corvel Wc	$30	7%
Health Select	$35 - $510	8%
Cigna	$39 - $601	9%
Aetna	$410 - $931	91%
Humana	$410	91%
Novitas Solutions	$436	97%
Triwest Va Ccn	$436	97%
Care Improvement Plus	$443	98%
Wellcare By Allwell	$458	102%
Caprock	$475 - $570	105%
Healthsmart Preferred Care	$475 - $712	105%
Group Resources	$532	118%
90 Degree Benefits	$570	126%
State Comptroller	$594	132%
Texas Mutual Wc	$783	174%
Geha	$808	179%
Firstcare	$831	184%
Workers Comp	$886	197%

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 $760.
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 Medical Center 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.