CMS Price Transparency Data

Blood transfusion

Facility: The Hospital at Westlake Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $388
Cash Discount Price: $848
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at The Hospital at Westlake Medical Center is $388. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $848. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.86x the Medicare baseline. Located in 5656 Bee Caves Road, Suite M-302, Austin, TX.

Cash / Self-Pay

$848

Average discount available for prompt cash payment at this facility.

Insurance Median

$388

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: $848 (188%)

Insurance Median: $388 (86%)

Cash: $848 (188% of Medicare)

Ins. Median: $388 (86% 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
United_Healthcare	$284	63%
Aetna	$388 - $1,164	86%
Ambetter / Centene	$388	86%
Blue Cross Blue Shield	$388 - $1,314	86%
Edhp	$388	86%
Humana	$388 - $1,611	86%
Mcr_United	$388	86%
Medicare (plans)	$388	86%
Sendero	$388	86%
Tricare	$388	86%
Triwest	$388	86%
Wellcare	$388	86%
Cigna	$521	116%
90_Degree_Benefits	$582	129%
Superior_Mcd	$1,115	247%
Scott_And_White	$1,363	302%
Multiplan	$1,611	357%
Beech_Street	$1,735	385%
Tx_Free_Market	$2,405	534%

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 $848.
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 Hospital at Westlake 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.