CMS Price Transparency Data

Blood transfusion

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $903
Cash Discount Price: $990
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Thomas H Boyd Memorial Hospital is $903. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $990. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.00x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$990

Average discount available for prompt cash payment at this facility.

Insurance Median

$903

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: $990 (220%)

Insurance Median: $903 (200%)

Cash: $990 (220% of Medicare)

Ins. Median: $903 (200% 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 200% of the Medicare baseline (a markup of 100%). 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
Aetna	$382 - $2,100	85%
Blue Cross Blue Shield	$382 - $2,100	85%
Health Alliance Mcr Adv	$382 - $974	85%
UnitedHealthcare	$382 - $994	85%
Wellcare Mcr Adv-All Plans	$382 - $974	85%
Humana	$386 - $984	86%
Health Alliance-All Other Plans	$458 - $1,169	102%
Ambetter / Centene	$497 - $1,266	110%
Cigna	$534 - $1,362	118%
Multiplan-All Plans	$562 - $1,432	125%
Healthlink Hmo	$569 - $1,452	126%
Healthlink Il Only	$569 - $1,452	126%
Healthlink Ppo-All Other Plans	$644 - $1,643	143%
Hfn Zelis-All Plans	$682 - $1,738	151%
Meridian Hp Mcaid-All Plans	$2,100	466%
Molina Mcaid-All Plans	$2,100	466%

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 $990.
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 Thomas H Boyd Memorial 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.