CMS Price Transparency Data

Blood transfusion

Facility: Major Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $675
Cash Discount Price: $256
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Major Hospital is $675. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.50x the Medicare baseline. Located in 2451 Intelliplex Dr, Shelbyville, IN.

Cash / Self-Pay

$256

Average discount available for prompt cash payment at this facility.

Insurance Median

$675

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: $256 (57%)

Insurance Median: $675 (150%)

Cash: $256 (57% of Medicare)

Ins. Median: $675 (150% 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
Blue Cross Blue Shield	$332 - $1,075	74%
Sho Direct-All Plans	$372 - $592	83%
UnitedHealthcare	$439 - $700	97%
Phcs - All Plans	$513 - $817	114%
Aetna	$567 - $903	126%
Siho-All Plans	$587 - $935	130%
Humana	$609 - $969	135%
First Health - All Plans	$634 - $1,010	141%
Cigna	$668 - $1,064	148%
Caresource Mrktplce -All Plans	$887	197%
Ambetter / Centene	$934	207%

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 $256.
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 Major 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.