CMS Price Transparency Data

Blood transfusion

Facility: Hill Country Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $621
Cash Discount Price: $3,188
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Hill Country Memorial Hospital is $621. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,188. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.38x the Medicare baseline. Located in 1020 South State Highway 16, Fredericksburg, TX.

Cash / Self-Pay

$3,188

Average discount available for prompt cash payment at this facility.

Insurance Median

$621

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: $3,188 (707%)

Insurance Median: $621 (138%)

Cash: $3,188 (707% of Medicare)

Ins. Median: $621 (138% 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
United	$31 - $2,147	7%
Molina Healthcare	$34	8%
Aetna	$39 - $2,386	9%
Superior Health	$80 - $948	18%
Community First Health Plans	$192 - $573	43%
Blue Cross Blue Shield	$335 - $2,071	74%
Wellcare	$465	103%
Cigna	$468 - $3,103	104%
Healthcare Highways	$494 - $1,470	110%
Curative Administrators	$641 - $1,909	142%
Healthsmart Preferred Care	$882 - $2,625	196%
Multiplan	$1,203 - $4,056	267%
Triwest Health Alliance	$1,203 - $3,579	267%

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 $3,188.
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 Hill Country Memorial 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.