CMS Price Transparency Data

Blood transfusion

Facility: Methodist McKinney Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $505
Cash Discount Price: $1,275
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Methodist McKinney Hospital is $505. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,275. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.12x the Medicare baseline. Located in 8000 W Eldorado Pkwy Bldg C Suite C, McKinney, TX.

Cash / Self-Pay

$1,275

Average discount available for prompt cash payment at this facility.

Insurance Median

$505

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: $1,275 (283%)

Insurance Median: $505 (112%)

Cash: $1,275 (283% of Medicare)

Ins. Median: $505 (112% 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
Champva [1000]	$420	93%
Tricare	$420	93%
Triwest Wps [8010]	$420	93%
Veterans Administration [9001]	$420	93%
Aetna	$433 - $1,626	96%
Blue Cross Blue Shield	$433 - $1,530	96%
Medicare (plans)	$433 - $464	96%
UnitedHealthcare	$433 - $464	96%
Ust Health Proof [1005]	$433	96%
Wellcare [7016]	$433	96%
American Health Advantage Of Texas [7099]	$455	101%
Cigna	$455 - $459	101%
Globalhealth [1003]	$455	101%
Procare Advantage [7018]	$455	101%
Humana	$459	102%
Southwestern Health Resources Swhr [7015]	$459	102%
Provider Partners Health Plan [7025]	$468	104%
Alternative Service Concepts [8005]	$542	120%
Oscar Insurance Company [2057]	$564	125%
Bright Healthcare [2222]	$607	135%
Molina [3017]	$629	140%
Wellpoint Marketplace Exchange [3071]	$672	149%
90 Degree Benefit [3057]	$715	159%
Allied National [2031]	$715	159%
Entrust/90 Degree [2058]	$715	159%
Friday Health Plan [2061]	$737	164%
Ambetter / Centene	$741	164%
Imperial Insurance Companies [3073]	$780	173%
Evry Health [1013]	$867	192%
Sana Benefits [3069]	$867	192%
Velocity [3070]	$867	192%
Web Tpa [3049]	$1,454 - $1,626	323%

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 $1,275.
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 Methodist McKinney Hospital 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.