CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital Springfield
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $454
- Cash Discount Price: $656
- vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Springfield is $454. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $656. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$656
Average discount available for prompt cash payment at this facility.
Insurance Median
$454
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: $656 (146%)
Insurance Median: $454 (101%)
Cash: $656 (146% of Medicare)
Ins. Median: $454 (101% 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 - $771 | 8% |
| Evolutions Health Care Contracted [320124] | $35 | 8% |
| Medicaid / KanCare | $35 - $3,263 | 8% |
| Point C Contracted [320238] | $105 - $757 | 23% |
| Medica Contracted [320239] | $305 - $399 | 68% |
| Medica [20239] | $305 - $399 | 68% |
| Benefit Management Contracted [320052] | $309 - $404 | 69% |
| Health Systems Inc Contracted [320174] | $309 - $404 | 69% |
| Insurance System Inc Contracted [320465] | $309 - $404 | 69% |
| Ambetter / Centene | $314 - $3,263 | 70% |
| Home State Health Plan Contracted [320187] | $314 - $3,263 | 70% |
| Novasys Contracted [320285] | $314 - $3,263 | 70% |
| Administrative Payor Contracted [320005] | $347 - $504 | 77% |
| Point C [20238] | $347 - $454 | 77% |
| Aetna | $386 - $504 | 86% |
| Medical Destinations Contracted [320242] | $386 - $504 | 86% |
| Mercy Benefit Admin Contracted [320251] | $386 - $605 | 86% |
| Workers Comp [20426] | $386 - $858 | 86% |
| Centurion Of Missouri [20459] | $388 | 86% |
| Champva [20065] | $388 | 86% |
| Cherokee Nation Health Serv Contracted [320066] | $388 | 86% |
| Cigna | $388 - $777 | 86% |
| Cross Timbers Hospice [20098] | $388 | 86% |
| Dept Of Veteran Affairs Contracted [320106] | $388 | 86% |
| Elara Caring Aspire Hospice [20433] | $388 | 86% |
| Globalhealth Contracted [320145] | $388 | 86% |
| Halo Hcr Inc Hospice Contracted [320432] | $388 | 86% |
| Halo Hcr Inc Hospice [20432] | $388 | 86% |
| Humana | $388 - $686 | 86% |
| Indian Health Service Contracted [320198] | $388 | 86% |
| Indian Health Service [20198] | $388 | 86% |
| Kindful Hospice Contracted [320434] | $388 | 86% |
| Kindful Hospice [20434] | $388 | 86% |
| Medicare (plans) | $388 - $408 | 86% |
| Mercy Hospice Okc [20252] | $388 | 86% |
| Mercy Mgd Behavioral Health Contracted [320259] | $388 | 86% |
| Mercy Rehab Hospital Contracted [320260] | $388 | 86% |
| Pace Of The Ozarks Contracted [320518] | $388 | 86% |
| Qual Choice Contracted [320325] | $388 | 86% |
| Tricare | $388 | 86% |
| UnitedHealthcare | $388 - $901 | 86% |
| United Medical Resources Contracted [320454] | $401 - $583 | 89% |
| Provider Partners Health Plans Contracted [320450] | $428 | 95% |
| First Health Contracted [320128] | $432 - $565 | 96% |
| Aither Health Contracted [320449] | $440 - $575 | 98% |
| Auxiant Contracted [320462] | $440 - $656 | 98% |
| Ebms Contracted [320493] | $440 - $575 | 98% |
| Edison Health Solutions Contracted [320502] | $440 - $575 | 98% |
| Healthlink Contracted [320179] | $440 - $807 | 98% |
| Imagine 360 Contracted [320494] | $440 - $575 | 98% |
| Reflect Health Contracted [320492] | $440 - $575 | 98% |
| Yuzu Health Contracted [320521] | $440 - $575 | 98% |
| 90 Degree Benefits Contracted [320436] | $463 - $605 | 103% |
| Federal Medical Center Contracted [320127] | $463 - $605 | 103% |
| Show-Me Health Administrators Contracted [320483] | $463 - $605 | 103% |
| Healthscope Contracted [320182] | $495 | 110% |
| Compcare Of The Ozarks Contracted [320437] | $610 - $797 | 135% |
| American Healthcare Alliance Contracted [320020] | $618 - $807 | 137% |
| Qual Choice Contracted [320324] | $618 - $807 | 137% |
| Municipal Health Plan Contracted [320271] | $625 - $817 | 139% |
| Centivo Contracted [320505] | $653 | 145% |
| Usa Managed Care Org Contracted [320429] | $679 - $888 | 151% |
| Ppo Plus Contracted [320310] | $695 - $908 | 154% |
| Providrs Care Network Contracted [320484] | $809 | 179% |