CMS Price Transparency Data

Blood transfusion

Facility: Texas Health Hospital Frisco

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,568
Cash Discount Price: $1,520
vs. Medicare Baseline: 3.48x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Texas Health Hospital Frisco is $1,568. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,520. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.48x the Medicare baseline. Located in 12400 N Dallas Parkway, Frisco, TX.

Cash / Self-Pay

$1,520

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,568

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: $1,520 (337%)

Insurance Median: $1,568 (348%)

Cash: $1,520 (337% of Medicare)

Ins. Median: $1,568 (348% 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 348% of the Medicare baseline (a markup of 248%). 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
Amerigroup	$31 - $465	7%
Blue Cross Blue Shield	$31 - $3,234	7%
Parkland	$31	7%
UnitedHealthcare	$31 - $2,135	7%
Superior Wellcare	$32 - $488	7%
Molina	$33 - $465	7%
American Health	$443	98%
Healthspring	$452	100%
Humana	$461	102%
Aetna	$521 - $2,748	116%
Fort Worth Firefighters	$557 - $2,393	124%
City Of Fort Worth	$596 - $1,843	132%
Cigna	$702 - $3,689	156%
Quick Trip	$761 - $2,470	169%
Phcs	$882 - $2,921	196%
Healthsmart	$952 - $3,293	211%
Multiplan	$1,104 - $3,411	245%
Galaxy	$1,117 - $3,450	248%
Usa	$1,117 - $3,450	248%

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 $1,520.
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 Texas Health Hospital Frisco 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.