CMS Price Transparency Data

Blood transfusion

Facility: Methodist Hospital Atascosa

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,352
Cash Discount Price: $4,713
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Methodist Hospital Atascosa is $1,352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,713. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.00x the Medicare baseline. Located in 1905 Hwy 97 East, Jourdanton, TX.

Cash / Self-Pay

$4,713

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,352

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: $4,713 (1046%)

Insurance Median: $1,352 (300%)

Cash: $4,713 (1046% of Medicare)

Ins. Median: $1,352 (300% 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 300% of the Medicare baseline (a markup of 200%). 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
Molina	$31	7%
United	$31 - $2,147	7%
Humana	$38	8%
Aetna	$39 - $2,386	9%
Superior Health	$233 - $948	52%
Blue Cross Blue Shield	$335 - $2,071	74%
Community First Health Plans	$365 - $573	81%
Wellcare	$465	103%
Imperial Insurance	$488	108%
Oscar	$931 - $3,007	207%
Cigna	$1,359 - $3,103	302%
Focus Health Solutions	$1,396 - $1,432	310%
Healthcare Highways	$1,433 - $1,470	318%
Valenz	$1,629 - $1,670	361%
Curative Administrators	$1,672 - $1,909	371%
Evry Health	$1,712 - $1,756	380%
Healthsmart Preferred Care	$2,559 - $2,625	568%
Multiplan	$3,490 - $4,056	774%
Triwest Health Alliance	$3,490 - $3,579	774%

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 $4,713.
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 Methodist Hospital Atascosa 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.