CMS Price Transparency Data

Blood transfusion

Facility: Doctors Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $2,085
  • Cash Discount Price: $4,117
  • vs. Medicare Baseline: 4.63x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Doctors Hospital is $2,085. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,117. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.63x the Medicare baseline. Located in 3651 Wheeler Road, Augusta, GA.
Cash / Self-Pay
$4,117

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,085

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: $4,117 (913%)
Insurance Median: $2,085 (463%)
Cash: $4,117 (913% of Medicare)
Ins. Median: $2,085 (463% 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 463% of the Medicare baseline (a markup of 363%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Cigna $519 - $3,132 115%
Amerigroup $585 - $2,365 130%
Ambetter / Centene $601 133%
United $642 - $1,852 142%
Friday Health $700 - $2,332 155%
Absolute Total Care $741 164%
Peach State $823 - $1,150 183%
Wellcare $823 - $1,150 183%
Aetna $881 - $3,633 195%
Prime Health $1,099 244%
Health One Alliance $1,116 - $1,894 248%
Rockport United Network $1,122 249%
Centurion $1,140 - $7,512 253%
Identity Mco $1,145 254%
Americas 1St Choice $1,153 - $2,205 256%
Medcost $2,062 - $2,630 457%
Blue Cross Blue Shield $2,085 - $2,761 463%
Kaiser Permanente $2,250 499%
Multiplan $2,470 - $3,705 548%
Nhc Advantage $2,550 566%
Pruitt Health $2,550 566%
Performax $2,799 621%
First Health $3,087 685%
Employer'S Health Network $3,293 731%
Novanet $3,705 822%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3651 Wheeler Road, Augusta, GA 30909
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals