CMS Price Transparency Data

Blood transfusion

Facility: Atrium Health Navicent the Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $435
  • Cash Discount Price: $585
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Atrium Health Navicent the Medical Center is $435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $585. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.97x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.
Cash / Self-Pay
$585

Average discount available for prompt cash payment at this facility.

Insurance Median
$435

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: $585 (130%)
Insurance Median: $435 (97%)
Cash: $585 (130% of Medicare)
Ins. Median: $435 (97% 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.

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
Aetna $37 - $807 8%
Blue Cross Blue Shield $37 - $2,433 8%
Georgia Health Advantage $37 - $426 8%
Humana $37 - $5,756 8%
UnitedHealthcare $37 - $426 8%
Care Source $38 - $434 8%
Clover $38 - $434 8%
Eon Health $38 - $434 8%
Pruitt Health $39 - $426 9%
Alliant $44 - $1,780 10%
Ambetter / Centene $50 - $596 11%
Cigna $68 - $1,681 15%
Securehealth $82 - $409 18%
Kaiser $91 - $1,997 20%
Multiplan $760 - $935 169%
Ibg $826 183%
Novanet $935 207%
Three Rivers Provider Network $994 221%
Beechstreet $1,087 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hemlock Street, Macon, GA 31201
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals