CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital Lebanon
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $416
- Cash Discount Price: $987
- vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Lebanon is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $987. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.92x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.
Cash / Self-Pay
$987
Average discount available for prompt cash payment at this facility.
Insurance Median
$416
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: $987 (219%)
Insurance Median: $416 (92%)
Cash: $987 (219% of Medicare)
Ins. Median: $416 (92% 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 |
|---|---|---|
| Blue Cross Blue Shield | $35 - $1,313 | 8% |
| Health Systems Inc Contracted [320174] | $35 | 8% |
| Indian Health Service Contracted [320198] | $35 | 8% |
| Insurance System Inc Contracted [320465] | $35 | 8% |
| Medicaid / KanCare | $91 - $615 | 20% |
| Ambetter / Centene | $109 - $455 | 24% |
| Home State Health Plan Contracted [320187] | $109 - $455 | 24% |
| Novasys Contracted [320285] | $109 - $455 | 24% |
| Medica Contracted [320239] | $144 - $600 | 32% |
| Medica [20239] | $144 - $600 | 32% |
| Administrative Payor Contracted [320005] | $164 - $683 | 36% |
| Healthlink Contracted [320179] | $237 - $1,290 | 53% |
| Preferred Health Plan Contracted [320522] | $237 - $987 | 53% |
| Cigna | $269 - $1,123 | 60% |
| 90 Degree Benefits Contracted [320436] | $273 - $1,138 | 61% |
| Aetna | $273 - $1,138 | 61% |
| Mercy Benefit Admin Contracted [320251] | $273 - $1,214 | 61% |
| Show-Me Health Administrators Contracted [320483] | $273 - $1,138 | 61% |
| United Medical Resources Contracted [320454] | $273 - $1,214 | 61% |
| UnitedHealthcare | $273 - $1,442 | 61% |
| Aither Health Contracted [320449] | $291 - $1,214 | 65% |
| Auxiant Contracted [320462] | $291 - $1,214 | 65% |
| Benefit Management Contracted [320052] | $291 - $1,214 | 65% |
| Ebms Contracted [320493] | $291 - $1,214 | 65% |
| Edison Health Solutions Contracted [320502] | $291 - $1,214 | 65% |
| Evolutions Health Care Contracted [320124] | $291 - $1,214 | 65% |
| First Health Contracted [320128] | $291 - $1,214 | 65% |
| Imagine 360 Contracted [320494] | $291 - $1,214 | 65% |
| Point C Contracted [320238] | $291 - $1,442 | 65% |
| Point C [20238] | $291 - $1,214 | 65% |
| Reflect Health Contracted [320492] | $291 - $1,214 | 65% |
| Workers Comp [20426] | $291 - $1,290 | 65% |
| Yuzu Health Contracted [320521] | $291 - $1,214 | 65% |
| American Healthcare Alliance Contracted [320020] | $309 - $1,290 | 69% |
| Humana | $309 - $1,290 | 69% |
| Usa Managed Care Org Contracted [320429] | $320 - $1,336 | 71% |
| Multiplan Contracted [320270] | $346 - $1,442 | 77% |
| Private Health Care Systems Contracted [320320] | $346 - $1,442 | 77% |
| Medicare (plans) | $400 - $424 | 89% |
| Champva [20065] | $416 | 92% |
| Cherokee Nation Health Serv Contracted [320066] | $416 | 92% |
| Cross Timbers Hospice [20098] | $416 | 92% |
| Dept Of Veteran Affairs Contracted [320106] | $416 | 92% |
| Elara Caring Aspire Hospice [20433] | $416 | 92% |
| Globalhealth Contracted [320145] | $416 | 92% |
| Halo Hcr Inc Hospice Contracted [320432] | $416 | 92% |
| Halo Hcr Inc Hospice [20432] | $416 | 92% |
| Kindful Hospice Contracted [320434] | $416 | 92% |
| Kindful Hospice [20434] | $416 | 92% |
| Mercy Hospice Okc [20252] | $416 | 92% |
| Mercy Mgd Behavioral Health Contracted [320259] | $416 | 92% |
| Pace Of The Ozarks Contracted [320518] | $416 | 92% |
| Provider Partners Health Plans Contracted [320450] | $416 | 92% |
| Qual Choice Contracted [320325] | $416 | 92% |
| Tricare | $416 | 92% |
| Healthscope Contracted [320182] | $530 | 118% |
| Centivo Contracted [320505] | $700 | 155% |