CMS Price Transparency Data

Blood transfusion

Facility: Kentucky River Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $731
Cash Discount Price: $822
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Kentucky River Medical Center is $731. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $822. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.62x the Medicare baseline. Located in 540 Jett Drive, Jackson, KY.

Cash / Self-Pay

$822

Average discount available for prompt cash payment at this facility.

Insurance Median

$731

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: $822 (182%)

Insurance Median: $731 (162%)

Cash: $822 (182% of Medicare)

Ins. Median: $731 (162% 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	$15 - $932	3%
Humana	$302 - $1,150	67%
UnitedHealthcare	$356 - $1,354	79%
Multiplan Primary Network-All Other Plans	$383 - $1,458	85%
Aetna	$447 - $1,701	99%
Cigna	$511 - $1,944	113%
Multiplan Complementary Network	$511 - $1,944	113%

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 $822.
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 Kentucky River Medical Center 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.