CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital Ozark
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $177
- Cash Discount Price: $643
- vs. Medicare Baseline: 0.39x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Ozark is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $643. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.39x the Medicare baseline. Located in 801 West River Street, Ozark, AR.
Cash / Self-Pay
$643
Average discount available for prompt cash payment at this facility.
Insurance Median
$177
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: $643 (143%)
Insurance Median: $177 (39%)
Cash: $643 (143% of Medicare)
Ins. Median: $177 (39% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $35 - $389 | 8% |
| Summit Community Care Contracted [320368] | $35 | 8% |
| Summit Community Care [20368] | $35 | 8% |
| Arkansas Total Care Contracted [320039] | $77 | 17% |
| Aetna | $128 - $283 | 28% |
| American Health Advantage Of Mo Mcr [20264] | $128 | 28% |
| Blue Cross Blue Shield | $128 | 28% |
| Cherokee Nation Health Serv Contracted [320066] | $128 | 28% |
| Cross Timbers Hospice [20098] | $128 | 28% |
| Dept Of Veteran Affairs Contracted [320106] | $128 | 28% |
| Elara Caring Aspire Hospice Contracted [320433] | $128 | 28% |
| Elara Caring Aspire Hospice [20433] | $128 | 28% |
| Globalhealth Contracted [320145] | $128 | 28% |
| Halo Hcr Inc Hospice Contracted [320432] | $128 | 28% |
| Halo Hcr Inc Hospice [20432] | $128 | 28% |
| Humana | $128 - $371 | 28% |
| Independent Health [20197] | $128 | 28% |
| Indian Health Service Contracted [320198] | $128 | 28% |
| Indian Health Service [20198] | $128 | 28% |
| Jordan Valley Senior Care Pace [20515] | $128 | 28% |
| Kindful Hospice Contracted [320434] | $128 | 28% |
| Kindful Hospice [20434] | $128 | 28% |
| Medical Associates Health [20444] | $128 | 28% |
| Medicare (plans) | $128 - $135 | 28% |
| Mercy Hospice Okc [20252] | $128 | 28% |
| Pace Of The Ozarks [20518] | $128 | 28% |
| Provider Partners Health Plans Contracted [320450] | $128 | 28% |
| Qual Choice Contracted [320325] | $128 | 28% |
| Spina Bifida Hlthcare Benefit [20506] | $128 | 28% |
| UnitedHealthcare | $128 - $298 | 28% |
| Valir Pace [20503] | $128 | 28% |
| Wellfirst Health Mcr [20443] | $128 | 28% |
| Tricare | $129 | 29% |
| Cigna | $135 - $371 | 30% |
| Mercy Interfacility [20513] | $143 | 32% |
| Ambetter / Centene | $177 | 39% |
| Home State Health Plan Contracted [320187] | $177 | 39% |
| Novasys Contracted [320285] | $177 - $305 | 39% |
| Auxiant Contracted [320462] | $262 - $392 | 58% |
| Mercy Benefit Admin Contracted [320251] | $262 - $392 | 58% |
| Qual Choice Contracted [320324] | $262 | 58% |
| Workers Comp [20426] | $283 | 63% |
| United Medical Resources Contracted [320454] | $298 | 66% |
| 90 Degree Benefits Contracted [320436] | $371 | 82% |
| Aither Health Contracted [320449] | $371 | 82% |
| Ebms Contracted [320493] | $371 | 82% |
| Edison Health Solutions Contracted [320502] | $371 | 82% |
| Healthlink Contracted [320179] | $371 - $392 | 82% |
| Imagine 360 Contracted [320494] | $371 | 82% |
| Multiplan Contracted [320270] | $371 | 82% |
| Multiplan [20270] | $371 | 82% |
| Municipal Health Plan Contracted [320271] | $371 | 82% |
| Reflect Health Contracted [320492] | $371 | 82% |
| Show-Me Health Administrators Contracted [320483] | $371 | 82% |
| Federal Medical Center Contracted [320127] | $392 | 87% |
| Healthscope Contracted [320182] | $392 | 87% |
| Insurance System Inc Contracted [320465] | $392 | 87% |
| Personify Health Contracted [320051] | $392 | 87% |
| Point C Contracted [320238] | $392 | 87% |
| Preferred Health Plan Contracted [320522] | $392 | 87% |
| Tri State Healthcare Coalition Contracted [320379] | $392 | 87% |
| Health Choice Contracted [320166] | $874 | 194% |