CMS Price Transparency Data

Blood transfusion

Facility: Methodist Southlake Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $755
  • Cash Discount Price: $1,275
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Methodist Southlake Medical Center is $755. 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 1.68x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$1,275

Average discount available for prompt cash payment at this facility.

Insurance Median
$755

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: $755 (168%)
Cash: $1,275 (283% of Medicare)
Ins. Median: $755 (168% 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.

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] $418 93%
Tricare $418 93%
Triwest Wps [8010] $418 93%
Veterans Administration [9001] $418 93%
Aetna $444 - $1,658 99%
Blue Cross Blue Shield $444 - $1,530 99%
Medicare (plans) $444 - $475 99%
UnitedHealthcare $444 - $1,450 99%
Ust Health Proof [1005] $444 99%
Wellcare [7016] $444 99%
American Health Advantage Of Texas [7099] $466 103%
Cigna $466 - $821 103%
Globalhealth [1003] $466 103%
Procare Advantage [7018] $466 103%
Humana $471 104%
Southwestern Health Resources Swhr [7015] $471 104%
Provider Partners Health Plan [7025] $479 106%
Alternative Service Concepts [8005] $555 123%
Oscar Insurance Company [2057] $577 128%
Bright Healthcare [2222] $621 138%
Molina [3017] $644 143%
Wellpoint Marketplace Exchange [3071] $688 153%
Kempton Group Administrators, Tower Extrusions [3061] $710 158%
90 Degree Benefit [3057] $732 162%
Allied National [2031] $732 162%
Entrust/90 Degree [2058] $732 162%
Friday Health Plan [2061] $755 168%
Ambetter / Centene $759 168%
Imperial Insurance Companies [3073] $799 177%
Web Tpa [3049] $821 - $1,658 182%
Department Of Labor [8004] $888 197%
Evry Health [1013] $888 197%
Generic Workers Comp Tx Non Par [9010] $888 197%
Generic Workers Comp Tx Par [8002] $888 197%
Generic Workers Comp Tx Par [9011] $888 197%
Sana Benefits [3069] $888 197%
Tristar Risk Management [8006] $888 197%
Velocity [3070] $888 197%
Health Plans Inc [5017] $1,110 246%
Medical Cost Containment Professionals [3059] $1,110 246%
Dart Member Care [3039] $1,199 266%
Healthscope Benefits [2052] $1,199 266%
Healthscope Benefits [3063] $1,199 266%
Scott & White Health Plan Trs [3062] $1,428 317%
Bind Benefits Inc [1004] $1,450 322%
Definity Health [3006] $1,450 322%
Freedom Life Insurance Company [2029] $1,450 322%
Geha Federal [3066] $1,450 322%
Tml Intergovernmental Employee Benefits [3050] $1,450 322%
Medicaid / KanCare $2,641 - $3,207 586%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 421 E State Highway 114, Southlake, TX 76092
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals