CMS Price Transparency Data

Blood transfusion

Facility: Piedmont Augusta Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,062
Cash Discount Price: $702
vs. Medicare Baseline: 2.36x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Piedmont Augusta Hospital is $1,062. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $702. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.36x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$702

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,062

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: $702 (156%)

Insurance Median: $1,062 (236%)

Cash: $702 (156% of Medicare)

Ins. Median: $1,062 (236% 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 236% of the Medicare baseline (a markup of 136%). 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
Absolute Total Care [20109]	$63	14%
Blue Cross Blue Shield	$379 - $2,338	84%
Medicaid / KanCare	$550	122%
Alliant Health Plans Of Georgia [10952]	$865	192%
Alliant Solocare [11101]	$865	192%
Medcost [10966]	$932	207%
Multiplan [10600]	$1,029	228%
Phcs [10601]	$1,029	228%
UnitedHealthcare	$1,095 - $1,685	243%
Industry Buying Group [10840]	$1,520	337%
Cigna	$1,590	353%
Aetna	$1,707	379%
Kaiser [10500]	$1,730	384%
First Health [10303]	$1,988	441%
Novanet [10819]	$2,105	467%

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 $702.
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 Piedmont Augusta Hospital 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.