CMS Price Transparency Data

Blood transfusion

Facility: Decatur County Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,208
Cash Discount Price: $1,282
vs. Medicare Baseline: 2.68x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Decatur County Memorial Hospital is $1,208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,282. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.68x the Medicare baseline. Located in 720 North Lincoln Street, Greensburg, IN.

Cash / Self-Pay

$1,282

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,208

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: $1,282 (284%)

Insurance Median: $1,208 (268%)

Cash: $1,282 (284% of Medicare)

Ins. Median: $1,208 (268% 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 268% of the Medicare baseline (a markup of 168%). 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
Blue Cross Blue Shield	$496 - $1,709	110%
Choice Care Mcr Adv	$496	110%
Siho Mcr Adv	$496	110%
UnitedHealthcare	$496 - $1,504	110%
Caresource Mcr Adv	$520	115%
Aetna	$581 - $1,299	129%
Caresource Just4Me-All Other Plans	$843	187%
Cigna	$1,316	292%
Sagamore Health-All Plans	$1,367	303%
Encircle-All Plans	$1,453	322%
Healthsource Indiana-All Plans	$1,538	341%
Choicecare Commercial-All Other Plans	$1,589	353%
Thcg/Encore-All Plans	$1,606	356%
Siho-All Other Plans	$1,658	368%
Medicaid / KanCare	$1,709	379%

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 $1,282.
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 Decatur County Memorial 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.