CMS Price Transparency Data

Blood transfusion

Facility: Rio Grande Regional Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $600
Cash Discount Price: $1,557
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Rio Grande Regional Hospital is $600. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,557. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.33x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$1,557

Average discount available for prompt cash payment at this facility.

Insurance Median

$600

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: $1,557 (345%)

Insurance Median: $600 (133%)

Cash: $1,557 (345% of Medicare)

Ins. Median: $600 (133% 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%
Driscoll Children'S Health Plan	$32	7%
United	$33 - $2,115	7%
Molina Healthcare	$34	8%
Aetna	$39 - $2,678	9%
Superior Health Plan	$97 - $948	22%
Blue Cross Blue Shield	$208 - $838	46%
Texas Athletic Network	$300 - $600	67%
Texas Workforce Commission	$333 - $447	74%
Healthcare Highways	$354 - $5,841	79%
Oscar	$378 - $2,625	84%
Humana	$426 - $5,055	95%
Cigna	$450 - $3,941	100%
Averde Health	$458 - $615	102%
Curative Administrators	$555 - $1,672	123%
Healthsmart Preferred Care	$597 - $1,584	132%
First Health	$798 - $1,071	177%
National Healthcare Solutions	$833 - $1,118	185%
Southwest Medical	$833 - $1,118	185%
Coastal Comp	$903 - $1,211	200%
Usa Managed Care	$903 - $1,491	200%
Ppo Next/ Medical Control	$1,042 - $1,397	231%
Beech Street	$1,111 - $1,491	246%
Multiplan	$1,111 - $1,491	246%
Independent Medical System	$2,940	652%

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 $1,557.
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 Rio Grande Regional 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.