CMS Price Transparency Data

Blood transfusion

Facility: Texas Orthopedic Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $141
  • Cash Discount Price: $427
  • vs. Medicare Baseline: 0.31x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Texas Orthopedic Hospital is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $427. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.31x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$427

Average discount available for prompt cash payment at this facility.

Insurance Median
$141

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: $427 (95%)
Insurance Median: $141 (31%)
Cash: $427 (95% of Medicare)
Ins. Median: $141 (31% 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.

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 Health Plan $12 - $948 3%
Amerigroup $27 - $92 6%
Cigna $29 - $2,942 6%
Texas Health Network $30 7%
Blue Cross Blue Shield $32 - $323 7%
Texas Childrens Health Plans $32 - $156 7%
United $33 - $1,702 7%
Community Health Choice Mcd $34 8%
Molina Healthcare $34 8%
Humana $38 - $4,690 8%
Oscar $38 - $2,358 8%
Aetna $39 - $2,663 9%
Texas Workforce Commission $47 - $158 10%
Healthcare Highways $50 - $5,841 11%
Evry Health $53 - $180 12%
Imagine Health $68 - $231 15%
Christus (Usfhp) $78 - $264 17%
Curative Administrators $78 - $1,672 17%
Healthsmart Preferred Care $84 - $560 19%
Averde Health $88 - $297 20%
Fidelis Securecare Of Tx $88 - $2,115 20%
Coventry National First Health $104 - $351 23%
Physicians Cooperative Of Texas $107 - $363 24%
Rockport Workers Comp $107 - $363 24%
Independent Medical System $117 - $396 26%
National Healthcare Solutions $117 - $396 26%
Southwest Medical $117 - $396 26%
Coastal Comp $127 - $429 28%
Multiplan $146 - $560 32%
International Health Insurance $156 - $527 35%
Physicians, Inc $166 - $560 37%
Affiliated Ppo $176 - $593 39%
Texas Athletic Network $300 - $600 67%
Wellmed $445 99%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals