CMS Price Transparency Data

Blood transfusion

Facility: Monroe Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $402
Cash Discount Price: $464
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Monroe Hospital is $402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $464. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.89x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$464

Average discount available for prompt cash payment at this facility.

Insurance Median

$402

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: $464 (103%)

Insurance Median: $402 (89%)

Cash: $464 (103% of Medicare)

Ins. Median: $402 (89% 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	$300 - $464	67%
Americas Choice Provider Network Acpn	$300 - $901	67%
Blue Cross Blue Shield	$300 - $1,940	67%
Care Source	$300 - $673	67%
Corvel Workers Compensation	$300 - $808	67%
Employer Direct Healthcare	$300 - $650	67%
Encore Health Network Workers Compensation	$300 - $910	67%
Medicaid / KanCare	$300 - $383	67%
Medicare (plans)	$300 - $464	67%
Monroe Medical Group And Managed Health Services	$300 - $627	67%
Multiplan	$300 - $901	67%
Prime Health Services	$300 - $901	67%
Provider Network Of America	$300 - $929	67%
Provider Partners Health Plan	$300 - $511	67%
Provider Select	$300 - $920	67%
Three Rivers	$300 - $901	67%
Tricare	$300 - $464	67%
UnitedHealthcare	$300 - $464	67%
Usa Senior Care Network	$300 - $464	67%
Workers Compensation	$300 - $929	67%
Worthington Christian Fellowship	$300 - $464	67%
Zelis Healthcare Fka Stratose	$300 - $882	67%

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 $464.
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 Monroe 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.