CMS Price Transparency Data

Blood transfusion

Facility: Community Hospital of Staunton

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $335
Cash Discount Price: $348
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Community Hospital of Staunton is $335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $348. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.74x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.

Cash / Self-Pay

$348

Average discount available for prompt cash payment at this facility.

Insurance Median

$335

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: $348 (77%)

Insurance Median: $335 (74%)

Cash: $348 (77% of Medicare)

Ins. Median: $335 (74% 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
Tricare	$38 - $305	8%
Medicare (plans)	$44 - $317	10%
Clear Spring Health Ma	$45 - $321	10%
Self Pay	$168 - $528	37%
Cigna	$216 - $680	48%
Blue Cross Blue Shield	$251 - $1,055	56%
Healthlink	$251 - $897	56%
Aetna	$271 - $1,055	60%
Health Alliance Commercial	$285 - $1,055	63%
Multiplan/Phcs	$285 - $897	63%
Beech Street	$305 - $960	68%
Medicaid / KanCare	$335 - $1,055	74%
UnitedHealthcare	$335 - $1,055	74%

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 $348.
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 Community Hospital of Staunton 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.