CMS Price Transparency Data

Blood transfusion

Facility: Methodist Celina Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $609
Cash Discount Price: $1,275
vs. Medicare Baseline: 1.35x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Methodist Celina Medical Center is $609. 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 1.35x the Medicare baseline. Located in 1500 S Dallas Parkway, Celina, TX.

Cash / Self-Pay

$1,275

Average discount available for prompt cash payment at this facility.

Insurance Median

$609

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: $609 (135%)

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

Ins. Median: $609 (135% 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	$443 - $718	98%
Blue Cross Blue Shield	$443 - $1,530	98%
Mcs Advantage, Inc Classicare [7021]	$443	98%
Medicare (plans)	$443 - $474	98%
UnitedHealthcare	$443 - $470	98%
Ust Health Proof [1005]	$443	98%
Wellcare [7016]	$443	98%
American Health Advantage Of Texas [7099]	$465	103%
Cigna	$465 - $470	103%
Humana	$470	104%
Southwestern Health Resources Swhr [7015]	$470	104%
Oscar Insurance Company [2057]	$576	128%
Molina [3017]	$643	143%
Wellpoint Marketplace Exchange [3071]	$687	152%
Kempton Group Administrators, Tower Extrusions [3061]	$709	157%
90 Degree Benefit [3057]	$731	162%
Allied National [2031]	$731	162%
Entrust/90 Degree [2058]	$731	162%
Department Of Labor [8004]	$886	197%
Evry Health [1013]	$886	197%
Generic Workers Comp Tx Non Par [9010]	$886	197%
Generic Workers Comp Tx Par [8002]	$886	197%
Generic Workers Comp Tx Par [9011]	$886	197%
Sana Benefits [3069]	$886	197%
Velocity [3070]	$886	197%
Health Plans Inc [5017]	$1,108	246%
Medical Cost Containment Professionals [3059]	$1,108	246%
Medicaid / KanCare	$1,920	426%

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 Celina Medical Center 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.