CMS Price Transparency Data

Blood transfusion

Facility: Alton Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $2,159
  • Cash Discount Price: $1,993
  • vs. Medicare Baseline: 4.79x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Alton Memorial Hospital is $2,159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,993. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.79x the Medicare baseline. Located in One Memorial Drive, Alton, IL.
Cash / Self-Pay
$1,993

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,159

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: $1,993 (442%)
Insurance Median: $2,159 (479%)
Cash: $1,993 (442% of Medicare)
Ins. Median: $2,159 (479% 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 479% of the Medicare baseline (a markup of 379%). 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
Healthscope Benefits [258] $406 90%
UnitedHealthcare $406 - $2,468 90%
Aetna $473 - $2,492 105%
Blue Cross Blue Shield $473 - $2,890 105%
Humana $473 - $1,847 105%
Essence Healthcare [221] $487 108%
Cox Health [757] $496 110%
Devoted Health Plan [847] $496 110%
Medica [662] $496 110%
Healthlink [225] $1,611 - $2,508 357%
Cigna $1,747 - $2,658 388%
Consociate [478] $1,794 398%
Sarah Bush Lincoln [636] $1,794 398%
Cox Health Systems Insurance Company [220] $1,827 - $2,458 405%
Health Alliance [224] $1,827 405%
Allied Benefits [498] $1,884 - $2,468 418%
Coresource [497] $1,884 418%
Fmh Benefit Service Inc [222] $1,884 418%
Mail Handlers [495] $1,884 418%
Apwu Health Plan [216] $1,897 421%
Nalc Health Benefit Plan [242] $1,897 421%
Priority Health [648] $1,897 421%
Hope Trust [806] $1,927 428%
Med-Pay [480] $2,159 - $2,492 479%
Unicare [568] $2,159 - $2,508 479%
First Health Commercial [734] $2,468 548%
Beechstreet [551] $2,492 553%
Detego Health [868] $2,492 553%
Health Systems Inc [620] $2,492 553%
Healthcare Sol Mercy [609] $2,492 553%
Multiplan Commercial [737] $2,492 553%
Multiplan [240] $2,492 553%
Phcs [244] $2,492 - $2,658 553%
Preferred Health Professionals [561] $2,508 556%
Hfn [563] $2,658 590%
Medica [661] $2,658 590%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Memorial Drive, Alton, IL 62002
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals