CMS Price Transparency Data

Blood transfusion

Facility: Franciscan Health Mooresville

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,862
Cash Discount Price: $727
vs. Medicare Baseline: 4.13x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Franciscan Health Mooresville is $1,862. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $727. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.13x the Medicare baseline. Located in 1201 Hadley Rd, Mooresville, IN.

Cash / Self-Pay

$727

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,862

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: $727 (161%)

Insurance Median: $1,862 (413%)

Cash: $727 (161% of Medicare)

Ins. Median: $1,862 (413% 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 413% of the Medicare baseline (a markup of 313%). 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
Medicare (plans)	$467 - $513	104%
Commercial [2001]	$527 - $5,012	117%
Managed Care [2000]	$527 - $4,761	117%
Aetna	$540 - $3,453	120%
UnitedHealthcare	$783 - $3,037	174%
United Medical Resources [1158]	$799 - $3,037	177%
United Medical Resources [1301]	$799 - $3,037	177%
Cigna	$840 - $3,193	186%
Great West Insurance [1055]	$857 - $3,258	190%
Humana	$918 - $3,492	204%
Workers Comp [1172]	$934	207%
Blue Cross Blue Shield	$1,129 - $1,980	250%
Unicare [1150]	$1,980	439%

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 $727.
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 Franciscan Health Mooresville 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.