CMS Price Transparency Data

Blood transfusion

Facility: Norton-King's Daughters' Health

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $899
Cash Discount Price: $233
vs. Medicare Baseline: 1.99x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Norton-King's Daughters' Health is $899. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.99x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$233

Average discount available for prompt cash payment at this facility.

Insurance Median

$899

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: $233 (52%)

Insurance Median: $899 (199%)

Cash: $233 (52% of Medicare)

Ins. Median: $899 (199% 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	$38 - $931	8%
Blue Cross Blue Shield	$38 - $781	8%
Humana	$38 - $458	8%
Managed Health Services Of Kentucky	$38	8%
Passport By Molina	$38	8%
UnitedHealthcare	$458 - $831	102%
Managed Health Services	$472 - $710	105%
Custom Design Benefits	$529 - $916	117%
Caresource Of Kentucky	$641	142%
Caresource Of Indiana	$687	152%
Cigna	$899	199%
Encore	$899	199%
Quality Care Partners	$942	209%
Bluegrass	$952	211%
First Health	$952	211%
Healthlink	$952	211%
Vha/Tristate	$952	211%
Multiplan/Phcs	$973	216%
Indiana Health Network	$1,005	223%
Siho	$1,005	223%

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 $233.
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 Norton-King's Daughters' Health 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.