CMS Price Transparency Data

Blood transfusion

Facility: Tift Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $865
Cash Discount Price: $581
vs. Medicare Baseline: 1.92x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Tift Regional Medical Center is $865. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $581. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 901 E 18Th Street, Tifton, GA.

Cash / Self-Pay

$581

Average discount available for prompt cash payment at this facility.

Insurance Median

$865

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: $581 (129%)

Insurance Median: $865 (192%)

Cash: $581 (129% of Medicare)

Ins. Median: $865 (192% 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
Tricare	$36 - $405	8%
Peach State Health Plan	$52	12%
Health One Alliance	$54 - $587	12%
Caresource Marketplace Exchange	$56 - $607	12%
Zelis Network Solutions	$63 - $810	14%
Wellcare	$205 - $406	45%
Amerigroup	$235 - $280	52%
Medicaid / KanCare	$235 - $280	52%
Peachstate	$247 - $294	55%
Caresource	$259 - $308	57%
Va Contract	$304	67%
Hospice	$398	88%
Medicare (plans)	$398	88%
Blue Cross Blue Shield	$405 - $1,244	90%
UnitedHealthcare	$405 - $1,051	90%
Aetna	$406 - $1,075	90%
Clover Health	$406	90%
Humana	$425 - $622	94%
Pruitt Health Premier	$438	97%
Self Pay 50	$523 - $622	116%
Misc Commercial Insurance Plans	$941 - $1,120	209%
Self Pay	$941 - $1,120	209%
Cigna	$955 - $1,136	212%
Misc Non Contracted Commercial Plans	$1,046 - $1,244	232%
Ga Workers Comp	$1,145	254%

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 $581.
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 Tift Regional 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.