CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital Jefferson
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $576
- Cash Discount Price: $654
- vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Jefferson is $576. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $654. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 1400 Us Highway 61, Crystal City, MO.
Cash / Self-Pay
$654
Average discount available for prompt cash payment at this facility.
Insurance Median
$576
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: $654 (145%)
Insurance Median: $576 (128%)
Cash: $654 (145% of Medicare)
Ins. Median: $576 (128% 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 | $60 - $615 | 13% |
| Aetna | $140 - $406 | 31% |
| Medica Contracted [320239] | $243 - $282 | 54% |
| Ambetter / Centene | $251 - $292 | 56% |
| Home State Health Plan Contracted [320187] | $251 - $292 | 56% |
| Novasys Contracted [320285] | $251 - $292 | 56% |
| Auxiant Contracted [320462] | $363 - $1,106 | 81% |
| Blue Cross Blue Shield | $363 - $973 | 81% |
| Mercy Benefit Admin Contracted [320251] | $363 - $1,106 | 81% |
| Show-Me Health Administrators Contracted [320483] | $363 - $1,073 | 81% |
| American Health Advantage Of Mo Mcr [10473] | $406 | 90% |
| Cherokee Nation Health Serv Contracted [320066] | $406 | 90% |
| Cross Timbers Hospice [20098] | $406 | 90% |
| Dept Of Veteran Affairs Contracted [320106] | $406 | 90% |
| Elara Caring Aspire Hospice Contracted [320433] | $406 | 90% |
| Elara Caring Aspire Hospice [20433] | $406 | 90% |
| Globalhealth Contracted [320145] | $406 | 90% |
| Halo Hcr Inc Hospice Contracted [320432] | $406 | 90% |
| Halo Hcr Inc Hospice [20432] | $406 | 90% |
| Humana | $406 | 90% |
| Kindful Hospice Contracted [320434] | $406 | 90% |
| Kindful Hospice [20434] | $406 | 90% |
| Medicare (plans) | $406 - $1,081 | 90% |
| Mercy Hospice Okc [20252] | $406 | 90% |
| Pace Of The Ozarks Contracted [320518] | $406 | 90% |
| Qual Choice Contracted [320325] | $406 | 90% |
| Tricare | $406 | 90% |
| UnitedHealthcare | $406 - $848 | 90% |
| Cigna | $414 - $883 | 92% |
| Hope Trust Contracted [320488] | $414 | 92% |
| Provider Partners Health Plans Contracted [320450] | $448 | 99% |
| Mercy Benefit Admin [20251] | $465 - $1,106 | 103% |
| Healthlink Contracted [320179] | $512 - $1,106 | 114% |
| Healthscope Contracted [320182] | $518 | 115% |
| Health Choices Contracted [320448] | $558 - $649 | 124% |
| Health Choices [20448] | $558 - $649 | 124% |
| Medical Associates Health Contracted [320444] | $558 - $649 | 124% |
| Federal Medical Center Contracted [320127] | $604 - $703 | 134% |
| Insurance System Inc Contracted [320465] | $604 - $703 | 134% |
| Point C Contracted [320238] | $604 - $703 | 134% |
| Tri State Healthcare Coalition Contracted [320379] | $604 - $703 | 134% |
| First Health Contracted [320128] | $651 - $768 | 144% |
| Mercy Mgd Behavioral Health Contracted [320259] | $651 - $757 | 144% |
| Multiplan Contracted [320270] | $651 - $811 | 144% |
| Private Health Care Systems Contracted [320320] | $651 - $757 | 144% |
| Centivo Contracted [320505] | $683 | 152% |
| Workers Comp [20426] | $698 - $865 | 155% |
| Preferred Health Plan Contracted [320522] | $725 | 161% |
| United Medical Resources Contracted [320454] | $848 | 188% |
| Aither Health Contracted [320449] | $1,106 | 245% |
| Aither Health [20449] | $1,106 | 245% |
| Ebms Contracted [320493] | $1,106 | 245% |
| Edison Health Solutions Contracted [320502] | $1,106 | 245% |
| Imagine 360 Contracted [320494] | $1,106 | 245% |
| Reflect Health Contracted [320492] | $1,106 | 245% |
| Yuzu Health Contracted [320521] | $1,106 | 245% |