CMS Price Transparency Data

Blood transfusion

Facility: St Marys Good Samaritan Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $181
Cash Discount Price: $436
vs. Medicare Baseline: 0.40x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at St Marys Good Samaritan Hospital is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.40x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.

Cash / Self-Pay

$436

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $436 (97%)

Insurance Median: $181 (40%)

Cash: $436 (97% of Medicare)

Ins. Median: $181 (40% 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
Peach State	$36	8%
Wellcare	$36 - $181	8%
Blue Cross Blue Shield	$130 - $484	29%
Aetna	$181 - $536	40%
Ambetter / Centene	$181	40%
Care Improvement Plus	$181	40%
Caresource	$181	40%
Cigna	$181 - $549	40%
Coventry	$181 - $502	40%
Eon Health Plan	$181	40%
Humana	$181 - $502	40%
Kaiser Permanente	$181	40%
Molina	$181	40%
Pruitthealth Premier	$181	40%
Todays Options Pffs	$181	40%
Todays Options Ppo	$181	40%
UnitedHealthcare	$181 - $2,632	40%
Vaccn United	$181	40%
First Health	$502	111%
Phcs	$502	111%
Meritain	$536	119%
Multiplan	$570 - $583	126%
Nova	$570 - $603	126%
Three Rivers Provider Network	$603	134%
Amerigroup	$670	149%

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 $436.
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 St Marys Good Samaritan 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.