CMS Price Transparency Data

Blood transfusion

Facility: Cook Childrens Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $810
Cash Discount Price: $1,513
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Cook Childrens Medical Center is $810. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,513. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.80x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.

Cash / Self-Pay

$1,513

Average discount available for prompt cash payment at this facility.

Insurance Median

$810

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: $1,513 (336%)

Insurance Median: $810 (180%)

Cash: $1,513 (336% of Medicare)

Ins. Median: $810 (180% 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
Health Plan W. Uhrip	$34 - $1,279	8%
Health Plan W/O Uhrip	$34 - $808	8%
Molina	$46 - $771	10%
United Community	$46 - $878	10%
Aetna	$49 - $2,860	11%
Beacon	$148 - $1,480	33%
Firstcare	$148 - $2,692	33%
Rightcare	$206 - $1,480	46%
Wellpoint	$217 - $1,182	48%
Blue Cross Blue Shield	$223 - $3,028	49%
El Paso Health First	$272 - $1,480	60%
Superior Health	$272 - $1,480	60%
Tx Children Health	$272 - $1,480	60%
UnitedHealthcare	$272 - $2,860	60%
S&W Health	$518 - $2,826	115%
Cigna	$525 - $2,860	116%
Healthscope	$525 - $2,860	116%
Imagine Health	$525 - $2,860	116%
Humana	$537 - $2,961	119%
Multiplan	$537 - $2,927	119%
First Health	$543 - $2,961	120%
Galaxy Health	$556 - $3,028	123%
Healthsmart	$556 - $3,028	123%
Usamco	$568 - $3,096	126%

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 $1,513.
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 Cook Childrens Medical Center 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.