CMS Price Transparency Data

Blood transfusion

Facility: Athur M Blank Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,085
Cash Discount Price: $1,667
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Athur M Blank Hospital is $1,085. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,667. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.41x the Medicare baseline. Located in 2220 North Druid Hills Road Ne, Atlanta, GA.

Cash / Self-Pay

$1,667

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,085

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: $1,667 (370%)

Insurance Median: $1,085 (241%)

Cash: $1,667 (370% of Medicare)

Ins. Median: $1,085 (241% 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 241% of the Medicare baseline (a markup of 141%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Peachstate [43]	$545 - $879	121%
Caresource [61]	$561 - $904	124%
Amerigroup [102]	$587 - $947	130%
Cigna	$843 - $1,360	187%
Blue Cross Blue Shield	$847 - $2,009	188%
United [5]	$847 - $1,365	188%
Ambetter / Centene	$854 - $1,378	189%
Oscar [228]	$855 - $1,379	190%
Aetna	$859 - $1,385	191%
Caresource Marketplace Bronze/Silver/Gold [60]	$867 - $1,398	192%
Kaiser [6]	$869 - $1,401	193%
Sidecar Health [236]	$880 - $1,420	195%
Direct Employer Agreements [72]	$893 - $1,749	198%
Coventry [9]	$896 - $1,444	199%
Northeast Georgia Heatlh System [808]	$957 - $1,544	212%
Veracity Benefits [809]	$957 - $1,544	212%
First Health [74]	$958 - $1,545	213%
Phcs [93]	$1,085 - $1,749	241%
Secure Health [340]	$1,085 - $1,749	241%
Beech Street [71]	$1,148 - $1,852	255%
Multiplan [92]	$1,250 - $2,017	277%
Novanet [41]	$1,276 - $2,058	283%

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 $1,667.
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 Athur M Blank 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.