CMS Price Transparency Data

Blood transfusion

Facility: North Austin Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $857
  • Cash Discount Price: $2,323
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at North Austin Medical Center is $857. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,323. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.90x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$2,323

Average discount available for prompt cash payment at this facility.

Insurance Median
$857

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: $2,323 (515%)
Insurance Median: $857 (190%)
Cash: $2,323 (515% of Medicare)
Ins. Median: $857 (190% 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
Amerigroup $29 6%
St David’S Hospice $31 7%
Blue Cross Blue Shield $32 - $799 7%
United $33 - $2,265 7%
Molina Healthcare $34 8%
Humana $38 8%
Sendero $38 8%
Aetna $43 - $5,457 10%
Superior Health Plan $116 - $929 26%
Oscar $446 - $2,455 99%
Moda $546 - $3,195 121%
Covenant Management Systems $669 148%
Healthcare Highways $676 - $14,612 150%
Imo Med - Select Network $697 155%
Nomi Health $743 - $1,520 165%
Cigna $746 - $3,015 166%
Moda Health $836 - $860 185%
Evry Health $855 - $17,365 190%
Texas Healthcare Foundation Heb $860 191%
Texas Workforce Commission $906 201%
Curative Administrators $929 - $1,672 206%
Harbor Health Team $929 - $1,800 206%
Averde Health $1,045 232%
UnitedHealthcare $1,045 232%
Comanche County $1,162 258%
National Choicecare $1,162 258%
Healthsmart Preferred Care $1,278 - $1,858 284%
Independent Medical Systems $1,278 284%
Physicians Cooperative Of Texas $1,278 284%
Prime Health $1,394 309%
First Health $1,452 - $1,649 322%
Coastal Comp Health Networks $1,510 335%
National Health Care $1,510 335%
Texas Municipal League $1,626 361%
Medcorp Southwest $1,742 386%
Rockport Healthcare Group $1,858 - $2,091 412%
Bce Emergis Corporation $2,091 464%
Beech Street $2,091 464%
Medical Control Network Solutions $2,091 464%
Multiplan $2,091 464%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals