CMS Price Transparency Data

Blood transfusion

Facility: Palos Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $484
Cash Discount Price: $1,160
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Palos Community Hospital is $484. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,160. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$1,160

Average discount available for prompt cash payment at this facility.

Insurance Median

$484

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: $1,160 (257%)

Insurance Median: $484 (107%)

Cash: $1,160 (257% of Medicare)

Ins. Median: $484 (107% 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
Blue Cross Blue Shield	$121 - $754	27%
Cigna	$141 - $754	31%
Aetna	$162 - $754	36%
UnitedHealthcare	$329 - $754	73%
Carelon Behavioral Health [159]	$377	84%
Healthlink [125]	$377 - $754	84%
First Health Plan [6034]	$428 - $566	95%
Magellan Behavioral Hlth [136]	$452	100%
The Alliance [1703]	$484	107%
Multiplan/Phcs [142]	$528 - $754	117%
Compsych [112]	$566	126%
Beechstreet [176]	$603	134%
Health'S Finest Network [126]	$641	142%
Galaxy Health Network [220]	$754	167%
Global Excel [1712]	$754	167%
Health Alliance [181]	$754	167%

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 $1,160.
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 Palos Community 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.