CMS Price Transparency Data

Blood transfusion

Facility: Mercy Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,225
Cash Discount Price: $621
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Mercy Regional Medical Center is $1,225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $621. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.72x the Medicare baseline. Located in 800 E Main, Ville Platte, LA.

Cash / Self-Pay

$621

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,225

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: $621 (138%)

Insurance Median: $1,225 (272%)

Cash: $621 (138% of Medicare)

Ins. Median: $1,225 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
Aetna	$134 - $278	30%
Mcd Hmo Amerigroup	$134 - $278	30%
Mcd Hmo La Care	$134 - $278	30%
Mcd Hmo La Hlth Cr Connct	$134 - $278	30%
Medicaid / KanCare	$134 - $2,301	30%
UnitedHealthcare	$136 - $1,189	30%
Mcd Hmo Com Hlth Solution	$148 - $306	33%
Charity/Map	$333 - $2,301	74%
Pp0/Manged Care	$556 - $2,301	123%
Ppo/Manged Care	$556 - $2,301	123%
Blue Cross Blue Shield	$748	166%
American Postal Workers	$889 - $1,841	197%
Work Comp	$1,000 - $2,071	222%
Commerical	$1,111 - $2,301	246%
Commerical Ip	$1,111 - $2,301	246%
Mcr American Hlth Adv	$1,111 - $2,301	246%
Medicare (plans)	$1,111 - $2,301	246%
Mra Auto/Liability	$1,111 - $2,301	246%
Tricare	$1,111 - $2,301	246%

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 $621.
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 Mercy Regional 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.