CMS Price Transparency Data

Blood transfusion

Facility: Texoma Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $787
Cash Discount Price: $2,185
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Texoma Medical Center is $787. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,185. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.75x the Medicare baseline. Located in 5016 S Us Highway 75, Denison, TX.

Cash / Self-Pay

$2,185

Average discount available for prompt cash payment at this facility.

Insurance Median

$787

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: $2,185 (485%)

Insurance Median: $787 (175%)

Cash: $2,185 (485% of Medicare)

Ins. Median: $787 (175% 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
Superior	$31 - $34	7%
Molina	$34 - $2,068	8%
Tchp	$34 - $1,189	8%
Blue_Cross_Blue_Shield_Of_Tx	$46 - $57	10%
Amerigroup	$52	12%
United_Healthcare	$52 - $1,189	12%
Cigna	$787 - $1,156	175%
Healthchoice	$787 - $2,185	175%
Aetna	$816	181%
Multiplan	$2,068	459%
Healthsmart	$2,185 - $3,247	485%
Humana	$3,247	720%

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 $2,185.
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 Texoma Medical 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.