CMS Price Transparency Data

Blood transfusion

Facility: Goshen Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $422
Cash Discount Price: $18,894
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Goshen Hospital is $422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18,894. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.94x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.

Cash / Self-Pay

$18,894

Average discount available for prompt cash payment at this facility.

Insurance Median

$422

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: $18,894 (4192%)

Insurance Median: $422 (94%)

Cash: $18,894 (4192% of Medicare)

Ins. Median: $422 (94% 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
Advantage Health Solutions	$422	94%
Aetna	$422	94%
Atrio Health Plans	$422	94%
Bc Federal Employee	$422	94%
Bc Mcr Advantage Ppo	$422	94%
Blue Cross Blue Shield	$422	94%
Buckeye Health Plan	$422	94%
Cigna	$422	94%
Coventry Health And Life	$422	94%
Emblem Health	$422	94%
Freedom Healthcare	$422	94%
Geisinger Health Plan	$422	94%
Health First	$422	94%
Healthspring	$422	94%
Humana	$422	94%
Iehp Empire Health Plan	$422	94%
Independent Care Health Plan	$422	94%
Kaiser Permanente	$422	94%
Mcr Advantra Freedom	$422	94%
Mcr Allwell Mhs	$422	94%
Mcr Banner Health	$422	94%
Mcr Complete	$422	94%
Mcr Complete Ppo	$422	94%
Mcr Complete Wellmed	$422	94%
Mcr Health Alliance	$422	94%
Mcr Health Partners Plans	$422	94%
Mcr Medical Mutual Of Ohio	$422	94%
Mcr Passport Advantage	$422	94%
Mcr Secure Horizons Ppo	$422	94%
Mcr Texan Plus	$422	94%
Mcr Upmc For Life	$422	94%
Medicare (plans)	$422 - $447	94%
Meridian Complete	$422	94%
Optimum Healthcare	$422	94%
Paramount Elite	$422	94%
Primetime Health Plan	$422	94%
Simply Complete Hmo	$422	94%
The Umwa H&R Funds	$422	94%
Todays Options Pyramid Life	$422	94%
Trillium Advantage	$422	94%
Ucare For Seniors	$422	94%
Ucare Minnesota	$422	94%
UnitedHealthcare	$422	94%
Wellcare	$422	94%
Champva	$434	96%
Tricare	$434	96%
Mcr Devoted Health Plan	$447	99%
Mcr Provider Partners Hlth Pln	$477	106%
Ambetter / Centene	$607	135%
Mkt Caresource	$607	135%

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 $18,894.
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 Goshen 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.