CMS Price Transparency Data

Blood transfusion

Facility: The Heart Hospital Baylor Denton

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $933
Cash Discount Price: $1,018
vs. Medicare Baseline: 2.07x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at The Heart Hospital Baylor Denton is $933. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,018. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.07x the Medicare baseline. Located in 2801 South Mayhill Road, Denton, TX.

Cash / Self-Pay

$1,018

Average discount available for prompt cash payment at this facility.

Insurance Median

$933

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: $1,018 (226%)

Insurance Median: $933 (207%)

Cash: $1,018 (226% of Medicare)

Ins. Median: $933 (207% 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 207% of the Medicare baseline (a markup of 107%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Superior Health Plan	$31 - $418	7%
Baylor Scott & White Health Plan	$378 - $984	84%
Humana	$398 - $1,187	88%
Triwest	$398	88%
Corvel	$417	93%
Prime Health Services	$417	93%
American Health Plan	$418	93%
Blue Cross Blue Shield	$418 - $1,255	93%
Healthspring	$418	93%
Procare Advantage	$418	93%
UnitedHealthcare	$458 - $1,172	102%
Ambetter / Centene	$824	183%
Cigna	$836 - $984	185%
Employers Health Network	$933	207%
Quiktrip	$933	207%
University Of Mary Hardin-Baylor	$984	218%
Imagine Health	$1,062	236%
Curative	$1,102	244%
First Health	$1,187	263%
Healthsmart	$1,187 - $1,272	263%
Private Health Care System	$1,272	282%
Aetna	$5,189	1151%

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 $1,018.
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 The Heart Hospital Baylor Denton 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.