CMS Price Transparency Data

Blood transfusion

Facility: Jacksonville Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $791
Cash Discount Price: $1,751
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Jacksonville Memorial Hospital is $791. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,751. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.75x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$1,751

Average discount available for prompt cash payment at this facility.

Insurance Median

$791

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: $1,751 (388%)

Insurance Median: $791 (175%)

Cash: $1,751 (388% of Medicare)

Ins. Median: $791 (175% 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	$39 - $460	9%
Blue Cross Blue Shield	$41 - $2,522	9%
Coventry	$43 - $397	10%
Health Alliance	$43 - $1,715	10%
Humana	$43 - $2,151	10%
Medicare (plans)	$43 - $397	10%
UnitedHealthcare	$45 - $1,816	10%
Corvel/Corcare	$118 - $648	26%
Illinois Workers Compensation	$126 - $1,342	28%
Health Alliance Mh Employee Plan	$451 - $1,160	100%
Commercial Workers Compensation	$495 - $1,275	110%
Current Health Network	$539 - $1,892	120%
6 Degrees Health	$588 - $1,513	130%
Hope Trust	$588 - $1,513	130%
Hst	$588 - $1,513	130%
Cigna	$679 - $1,748	151%
Aetna	$685 - $2,018	152%
Healthlink	$784 - $2,144	174%
Medicaid / KanCare	$791 - $2,522	175%
Molina Healthcare	$791 - $2,522	175%
Phcs/Multiplan	$882 - $2,270	196%
Hfn	$931 - $2,396	207%
Liability	$980 - $2,522	217%

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 $1,751.
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 Jacksonville 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.