CMS Price Transparency Data

Blood transfusion

Facility: Baylor Scott & White Medical Center Pflugerville

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $836
Cash Discount Price: $1,017
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Baylor Scott & White Medical Center Pflugerville is $836. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,017. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.85x the Medicare baseline. Located in 2600 East Pflugerville Parkway, Pflugerville, TX.

Cash / Self-Pay

$1,017

Average discount available for prompt cash payment at this facility.

Insurance Median

$836

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: $1,017 (226%)

Insurance Median: $836 (185%)

Cash: $1,017 (226% of Medicare)

Ins. Median: $836 (185% 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
Superior Health Plan	$31 - $388	7%
Baylor Scott & White Health Plan	$369 - $726	82%
Humana	$388 - $1,187	86%
Triwest	$388	86%
Corvel	$407	90%
Prime Health Services	$407	90%
American Health Plan	$408	91%
Healthspring	$408	91%
Procare Advantage	$408	91%
UnitedHealthcare	$447 - $1,171	99%
Sedgwick	$581	129%
Blue Cross Blue Shield	$780 - $949	173%
Cigna	$805 - $939	179%
Midcoast	$932	207%
Quiktrip	$932	207%
University Of Mary Hardin-Baylor	$983	218%
Independent Medical System	$1,017	226%
Curative	$1,102	244%
First Health	$1,187	263%
Healthsmart	$1,187 - $1,271	263%
Private Health Care System	$1,271	282%
Three Rivers	$1,526	339%
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 $1,017.
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 Pflugerville 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.