CMS Price Transparency Data

Blood transfusion

Facility: HCA Houston Healthcare Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $965
  • Cash Discount Price: $3,331
  • vs. Medicare Baseline: 2.14x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at HCA Houston Healthcare Medical Center is $965. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,331. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.14x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
$3,331

Average discount available for prompt cash payment at this facility.

Insurance Median
$965

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: $3,331 (739%)
Insurance Median: $965 (214%)
Cash: $3,331 (739% of Medicare)
Ins. Median: $965 (214% 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 214% of the Medicare baseline (a markup of 114%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $33 - $1,702 7%
Community Health Choice Mcd $34 8%
Molina Healthcare $34 8%
Humana $38 - $4,690 8%
Aetna $39 - $2,947 9%
Superior Health Plan $180 - $948 40%
Blue Cross Blue Shield $253 - $1,304 56%
Cigna $443 - $3,128 98%
Oscar $584 - $2,358 130%
Healthcare Highways $763 - $5,841 169%
Evry Health $817 - $1,017 181%
Christus (Usfhp) $1,197 - $1,490 266%
Curative Administrators $1,197 - $1,672 266%
Coventry National First Health $1,595 - $1,986 354%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals