CMS Price Transparency Data

Blood transfusion

Facility: Medical City Lewisville

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $657
Cash Discount Price: $2,227
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Medical City Lewisville is $657. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,227. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.46x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.

Cash / Self-Pay

$2,227

Average discount available for prompt cash payment at this facility.

Insurance Median

$657

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: $2,227 (494%)

Insurance Median: $657 (146%)

Cash: $2,227 (494% of Medicare)

Ins. Median: $657 (146% 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
Texas Health Network	$30	7%
Cook Childrens Health Plan	$31	7%
Parkland Community Health Plan	$31	7%
United	$31 - $2,174	7%
Amerigroup	$32	7%
Cigna	$32 - $2,960	7%
Molina	$34	8%
Aetna	$37 - $4,332	8%
Humana	$38 - $241	8%
Blue Cross Blue Shield	$43 - $989	10%
Superior Health Plan	$156	35%
Wellmed	$445	99%
Oscar	$463 - $2,636	103%
Unicare	$534 - $2,227	118%
Healthcare Highways	$546 - $2,069	121%
Evry Health	$575 - $2,287	128%
Curative Administrators	$891 - $1,672	198%
City Of Mckinney	$1,002	222%
Fidelis Securecare	$1,002 - $1,995	222%
National Choicecare	$1,113	247%
Pc Texas Partners	$1,225	272%
Physicians Coop Of Tx	$1,225	272%
Rockport Health Group	$1,225	272%
Averde Health, Inc	$1,292	287%
Usc Health Services	$1,336	296%
Coastal Comp Health Networks	$1,559	346%
Jostens	$1,559	346%
Mega Life	$1,559	346%
Multiplan Phcs	$1,559	346%
Healthsmart Preferred Care	$1,670	371%
Lewisville Isd/Dls Consulting	$1,670	371%
Usa Managed Care	$1,782	395%
Galaxy Health Network	$1,893	420%
Independent Medical Systems	$2,227	494%
National Healthcare Solutions	$2,227	494%

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 $2,227.
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 City Lewisville 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.