CMS Price Transparency Data

Blood transfusion

Facility: Kosciusko Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $1,305
  • Cash Discount Price: $864
  • vs. Medicare Baseline: 2.90x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Kosciusko Community Hospital is $1,305. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $864. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.90x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$864

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,305

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: $864 (192%)
Insurance Median: $1,305 (290%)
Cash: $864 (192% of Medicare)
Ins. Median: $1,305 (290% 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 290% of the Medicare baseline (a markup of 190%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Veterans Eval Services $38 8%
One Call Care Diagnostics Wc $44 10%
Blue Cross Blue Shield $383 - $1,918 85%
Caresource $383 85%
Humana $383 - $492 85%
Managed Health Services $383 85%
Medicaid / KanCare $383 85%
Mhs $383 - $492 85%
UnitedHealthcare $383 - $25,345 85%
Tricare $443 - $6,899 98%
Amish Aid $465 - $10,119 103%
Self Pay $465 - $10,119 103%
Department Of Veterans Affairs $467 - $7,262 104%
Aetna $492 - $25,634 109%
Medicare (plans) $492 109%
Iu Health $500 111%
Node Non Par Hospice Agree $500 111%
Node Va $500 111%
Node Devoted Health Mcr Adv $502 111%
In Dept Of Correction $520 115%
Node Pphp Mcr Adv $525 116%
Us Department Of Labor $625 139%
Lutheran Preferred Network $700 - $38,547 155%
Lutheran Advanced Network $750 166%
Lutheran Preferred $750 - $1,000 166%
Align In Work Comp $800 177%
One Call Work Comp $800 177%
Physicians Health Plan $818 - $22,203 181%
Php Freedom Network $856 - $18,609 190%
Encore $886 - $19,274 197%
Trma Inc $886 - $21,683 197%
Encore Work Comp In $900 200%
Prime Health Services $900 - $36,138 200%
Managed Health Services Exchange $1,000 222%
Workers Comp $1,000 222%
Encore Kba Epo $1,200 266%
Connecticut General Life Insurance Company $1,305 - $28,380 290%
Cigna $1,401 - $30,452 311%
Encore Kba Ppo $1,500 333%
First Health Network $1,662 - $36,138 369%
Advantage Health $1,839 - $39,993 408%
Private Healthcare Systems $1,906 - $41,438 423%
Sagamore $1,950 - $45,293 433%
Encore Health Network $2,061 - $44,811 457%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals