CMS Price Transparency Data

Blood transfusion

Facility: Harrison County Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $493
Cash Discount Price: $455
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Harrison County Community Hospital is $493. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $455. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.09x the Medicare baseline. Located in 2600 Miller Street, Bethany, MO.

Cash / Self-Pay

$455

Average discount available for prompt cash payment at this facility.

Insurance Median

$493

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: $455 (101%)

Insurance Median: $493 (109%)

Cash: $455 (101% of Medicare)

Ins. Median: $493 (109% 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
Multiplan	$32 - $600	7%
Cigna	$36 - $600	8%
Provider Partners Health Plans	$36 - $470	8%
Care Improvement Plus	$37 - $435	8%
Blue Cross Blue Shield	$38 - $660	8%
Allwell	$41 - $435	9%
Ambetter / Centene	$41 - $435	9%
Blue Advantage Plus	$41 - $435	9%
Humana	$41 - $675	9%
UnitedHealthcare	$41 - $638	9%
Aetna	$50 - $660	11%
6 Degrees Health	$52 - $600	12%
Healthy Blue	$493	109%
Home State	$493	109%
Wellmark	$520 - $600	115%

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 $455.
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 Harrison County Community Hospital 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.