CMS Price Transparency Data

Blood transfusion

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $909
Cash Discount Price: $1,061
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Baylor Scott & White Medical Center - Marble Falls is $909. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,061. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.02x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$1,061

Average discount available for prompt cash payment at this facility.

Insurance Median

$909

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: $1,061 (235%)

Insurance Median: $909 (202%)

Cash: $1,061 (235% of Medicare)

Ins. Median: $909 (202% 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 202% of the Medicare baseline (a markup of 102%). 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 - $383	7%
Baylor Scott & White Health Plan	$364 - $757	81%
Humana	$383 - $1,238	85%
Triwest	$383	85%
Corvel	$401	89%
Prime Health Services	$401	89%
American Health Plan	$402	89%
Blue Cross Blue Shield	$402 - $990	89%
Healthspring	$402	89%
Procare Advantage	$402	89%
UnitedHealthcare	$440 - $978	98%
Sedgwick	$572	127%
Cigna	$909 - $1,066	202%
Midcoast	$972	216%
Quiktrip	$972	216%
University Of Mary Hardin-Baylor	$1,026	228%
Independent Medical System	$1,061	235%
Curative	$1,149	255%
First Health	$1,238	275%
Healthsmart	$1,238 - $1,326	275%
Bluebell Creameries	$1,326	294%
Private Health Care System	$1,326	294%
Three Rivers	$1,591	353%
Aetna	$3,066	680%

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 $1,061.
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 Baylor Scott & White Medical Center - Marble Falls 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.