CMS Price Transparency Data

Blood transfusion

Facility: Johnson Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $790
Cash Discount Price: $1,044
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Johnson Memorial Hospital is $790. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,044. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.75x the Medicare baseline. Located in 1125 W Jefferson St, Franklin, IN.

Cash / Self-Pay

$1,044

Average discount available for prompt cash payment at this facility.

Insurance Median

$790

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: $1,044 (232%)

Insurance Median: $790 (175%)

Cash: $1,044 (232% of Medicare)

Ins. Median: $790 (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
Aetna	$467 - $1,031	104%
Blue Cross Blue Shield	$467 - $1,305	104%
Humana	$467 - $1,018	104%
Cigna	$775	172%
Unified Group - All Plans	$790	175%
Encore - All Plans	$900	200%
UnitedHealthcare	$914 - $955	203%
Siho - All Plans	$1,174	260%
Multiplan - All Plans	$1,266	281%

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 $1,044.
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 Johnson 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.