CMS Price Transparency Data

Blood transfusion

Facility: Cox Medical Centers

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $364
Cash Discount Price: $405
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Cox Medical Centers is $364. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $405. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.81x the Medicare baseline. Located in 3801 South National Avenue, Springfield, MO.

Cash / Self-Pay

$405

Average discount available for prompt cash payment at this facility.

Insurance Median

$364

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: $405 (90%)

Insurance Median: $364 (81%)

Cash: $405 (90% of Medicare)

Ins. Median: $364 (81% 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
Parkcrest Dental Group	$244	54%
Coastal Energy Corporation	$246	55%
Heart Of America Beverage Company	$251	56%
Loren Cook	$256	57%
Springfieldgreene Co Library	$261	58%
Src Holdings Corporation	$263	58%
Ozark Anesthesia Assoc. Inc	$266	59%
Missouri Affiliated School Consortium (Masc)	$274	61%
Justice Furniture And Bedding Co	$275	61%
The Durham Company	$275	61%
Ozark County	$277	61%
Ozarks Cocacola	$280	62%
Flora Farms	$285	63%
Advanced Concrete Technology	$288	64%
Cox Healthplans	$440	98%
Health Net Federal Services	$440	98%
Humana	$440	98%
Medrisk Llc	$440	98%
UnitedHealthcare	$440 - $520	98%
Blue Cross Blue Shield	$446	99%
Allwell	$453	101%
Devoted	$470	104%
Provider Partners Health Plan	$470	104%
Texas Co Memorial Hospital	$795	176%
Bjc Health Solutions	$858 - $1,607	190%
Cigna	$3,468	769%

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 $405.
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 Cox Medical Centers 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.