CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital Joplin
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $487
- Cash Discount Price: $562
- vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Joplin is $487. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $562. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.08x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$562
Average discount available for prompt cash payment at this facility.
Insurance Median
$487
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: $562 (125%)
Insurance Median: $487 (108%)
Cash: $562 (125% of Medicare)
Ins. Median: $487 (108% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $21 - $671 | 5% |
| Blue Cross Blue Shield | $26 - $631 | 6% |
| Indian Health Service Contracted [320198] | $35 - $562 | 8% |
| Point C Contracted [320238] | $109 - $692 | 24% |
| Ambetter / Centene | $239 - $242 | 53% |
| Home State Health Plan Contracted [320187] | $239 - $242 | 53% |
| Novasys Contracted [320285] | $239 - $242 | 53% |
| Humana | $256 - $389 | 57% |
| Medica Contracted [320239] | $311 - $315 | 69% |
| UnitedHealthcare | $342 - $559 | 76% |
| United Medical Resources Contracted [320454] | $350 - $571 | 78% |
| Benefit Management Contracted [320052] | $367 - $372 | 81% |
| Health Systems Inc Contracted [320174] | $367 - $372 | 81% |
| Insurance System Inc Contracted [320465] | $367 - $372 | 81% |
| Administrative Payor Contracted [320005] | $384 - $389 | 85% |
| Aetna | $389 - $536 | 86% |
| Champva [20065] | $389 | 86% |
| Cherokee Nation Health Serv Contracted [320066] | $389 | 86% |
| Cigna | $389 - $666 | 86% |
| Cross Timbers Hospice [20098] | $389 | 86% |
| Dept Of Veteran Affairs Contracted [320106] | $389 | 86% |
| Elara Caring Aspire Hospice [20433] | $389 | 86% |
| Globalhealth Contracted [320145] | $389 | 86% |
| Halo Hcr Inc Hospice Contracted [320432] | $389 | 86% |
| Halo Hcr Inc Hospice [20432] | $389 | 86% |
| Kindful Hospice Contracted [320434] | $389 | 86% |
| Kindful Hospice [20434] | $389 | 86% |
| Medicare (plans) | $389 - $409 | 86% |
| Mercy Hospice Okc [20252] | $389 | 86% |
| Mercy Mgd Behavioral Health Contracted [320259] | $389 | 86% |
| Pace Of The Ozarks Contracted [320518] | $389 | 86% |
| Provider Partners Health Plans Contracted [320450] | $389 | 86% |
| Qual Choice Contracted [320325] | $389 | 86% |
| Tricare | $389 | 86% |
| Centivo Contracted [320505] | $397 | 88% |
| Mercy Benefit Admin Contracted [320251] | $427 - $519 | 95% |
| Aither Health Contracted [320449] | $487 - $493 | 108% |
| Auxiant Contracted [320462] | $487 - $562 | 108% |
| Ebms Contracted [320493] | $487 - $493 | 108% |
| Edison Health Solutions Contracted [320502] | $487 - $493 | 108% |
| Healthlink Contracted [320179] | $487 - $692 | 108% |
| Imagine 360 Contracted [320494] | $487 - $493 | 108% |
| Reflect Health Contracted [320492] | $487 - $493 | 108% |
| Yuzu Health Contracted [320521] | $487 - $493 | 108% |
| Healthscope Contracted [320182] | $496 | 110% |
| 90 Degree Benefits Contracted [320436] | $512 - $519 | 114% |
| Show-Me Health Administrators Contracted [320483] | $512 - $519 | 114% |
| Preferred Health Plan Contracted [320522] | $555 - $562 | 123% |
| First Health Contracted [320128] | $582 - $589 | 129% |
| American Healthcare Alliance Contracted [320020] | $598 - $606 | 133% |
| Point C [20238] | $683 - $692 | 152% |
| Workers Comp [20426] | $683 - $865 | 152% |
| Health Choice Contracted [320166] | $743 | 165% |
| Usa Managed Care Org Contracted [320429] | $752 - $761 | 167% |
| Ppo Plus Contracted [320310] | $769 - $778 | 171% |
| Providrs Care Network Contracted [320484] | $809 | 179% |