CMS Price Transparency Data

Blood transfusion

Facility: T J Samson Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $458
Cash Discount Price: $488
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at T J Samson Community Hospital is $458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $488. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.02x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$488

Average discount available for prompt cash payment at this facility.

Insurance Median

$458

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: $488 (108%)

Insurance Median: $458 (102%)

Cash: $488 (108% of Medicare)

Ins. Median: $458 (102% 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	$15	3%
Humana	$15 - $449	3%
Molina Mcaid	$15	3%
Wellcare Mcaid	$440	98%
Blue Cross Blue Shield	$449 - $638	100%
Wellcare Mcr Adv - All Other Plans	$449	100%
Signature Health - All Plans	$453	101%
Molina Mcr Adv	$458	102%
Devoted Mcr Adv - All Plans	$471	104%
UnitedHealthcare	$583	129%
Center Care Select - All Plans	$638	142%
Caresource - All Plans	$673	149%
Molina Marketplace - All Other Plans	$673	149%
Phcs/Multiplan - All Plans	$705	156%
First Health - All Plans	$712	158%

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 $488.
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 T J Samson Community 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.