CMS Price Transparency Data

Blood transfusion

Facility: Memorial Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,513
Cash Discount Price: $2,522
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Memorial Medical Center is $1,513. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,522. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.36x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$2,522

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,513

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: $2,522 (560%)

Insurance Median: $1,513 (336%)

Cash: $2,522 (560% of Medicare)

Ins. Median: $1,513 (336% 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 336% of the Medicare baseline (a markup of 236%). 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
Blue Cross Blue Shield	$43 - $2,522	10%
Veterans Administration	$335	74%
Aetna	$465 - $1,917	103%
Health Alliance	$465 - $1,664	103%
Medicare (plans)	$465 - $2,522	103%
Tricare	$465	103%
UnitedHealthcare	$465 - $1,564	103%
Humana	$488 - $1,513	108%
Medicaid / KanCare	$507 - $2,522	112%
Molina	$517 - $630	115%
Commercial Workers Compensation	$716 - $1,275	159%
Illinois Workers Compensation	$754 - $1,342	167%
Healthlink	$1,009 - $1,589	224%
Current Health Network Ppo	$1,135	252%
Cigna	$1,324	294%
Phcs/Multiplan	$1,362 - $1,513	302%
6 Degrees Health	$1,513	336%
Hopetrust	$1,513	336%
Hst	$1,513	336%
Magellan	$1,513	336%
Consociate	$1,639	364%
Hfn	$1,639	364%
Preferred Plan	$1,892	420%
Soi Mcfarland	$1,892	420%
Soi Rushville	$1,892	420%
Corvel	$2,018	448%
Methodist First Choice	$2,018	448%
Mutual Medical Plans	$2,144	476%
Liability	$2,522	560%

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 $2,522.
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 Memorial Medical Center 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.