CMS Price Transparency Data

Blood transfusion

Facility: Henry County Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,257
Cash Discount Price: $1,128
vs. Medicare Baseline: 2.79x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Henry County Memorial Hospital is $1,257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,128. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.79x the Medicare baseline. Located in 1000 N 16Th St, New Castle, IN.

Cash / Self-Pay

$1,128

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,257

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: $1,128 (250%)

Insurance Median: $1,257 (279%)

Cash: $1,128 (250% of Medicare)

Ins. Median: $1,257 (279% 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 279% of the Medicare baseline (a markup of 179%). 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
Blue Cross Blue Shield	$473 - $1,643	105%
Caresource Hip	$473	105%
Humana	$473 - $1,446	105%
Caresource Mcr Adv	$483	107%
Caresource Marketplace-All Other Plans	$899	199%
Cigna	$1,075 - $1,117	239%
Caresource Just4Me	$1,183	262%
UnitedHealthcare	$1,287 - $1,337	286%
Aetna	$1,344 - $1,396	298%
Health Alliance-All Plans	$1,344 - $1,396	298%
Workers Comp - All Plans	$1,423 - $1,479	316%
Encore Workers Comp-All Plans	$1,502 - $1,561	333%
Caresource Mcaid	$1,629 - $1,692	361%

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 $1,128.
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 Henry County 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.