CMS Price Transparency Data

Blood transfusion

Facility: Atrium Health Navicent Peach

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $199
Cash Discount Price: $253
vs. Medicare Baseline: 0.44x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Atrium Health Navicent Peach is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.44x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$253

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $253 (56%)

Insurance Median: $199 (44%)

Cash: $253 (56% of Medicare)

Ins. Median: $199 (44% 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
Aetna	$43 - $298	10%
Blue Cross Blue Shield	$43 - $2,120	10%
Care Source	$43 - $108	10%
Clover	$43 - $108	10%
Eon Health	$43 - $108	10%
Georgia Health Advantage	$43 - $106	10%
Humana	$43 - $429	10%
UnitedHealthcare	$43 - $318	10%
Alliant	$44 - $2,054	10%
Pruitt Health	$45 - $106	10%
Ambetter / Centene	$48 - $258	11%
Cigna	$68 - $368	15%
Securehealth	$82 - $328	18%
Multiplan	$328 - $404	73%
Novanet	$404	90%
Three Rivers Provider Network	$429	95%
Beechstreet	$470	104%

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 $253.
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 Atrium Health Navicent Peach 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.