CMS Price Transparency Data

Blood transfusion

Facility: Hermann Area District Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $319
  • Cash Discount Price: $342
  • vs. Medicare Baseline: 0.71x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Hermann Area District Hospital is $319. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $342. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.71x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$342

Average discount available for prompt cash payment at this facility.

Insurance Median
$319

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: $342 (76%)
Insurance Median: $319 (71%)
Cash: $342 (76% of Medicare)
Ins. Median: $319 (71% 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
Healthy Blue Mcaid - All Plans $40 9%
Ambetter / Centene $41 - $458 9%
Blue Cross Blue Shield $43 - $530 10%
UnitedHealthcare $43 - $661 10%
Tricare $194 - $258 43%
Choicecare Mcr Adv- All Plans $206 - $273 46%
American Hlth Mcr Adv- All Plans $216 - $286 48%
Humana $216 - $286 48%
Aetna $220 - $618 49%
Wellcare Mcr Adv - All Plans $220 - $292 49%
Harmony Hp Mcaid- All Plans $284 - $378 63%
Cigna $291 - $387 65%
Care Partners Mcaid- All Plans $294 - $391 65%
Healthcare Usa Mcaid- All Plans $319 - $423 71%
Healthlink Hmo $319 - $423 71%
Healthlink Ppo - All Other Plans $368 - $488 82%
Multiplan/Phcs - All Plans $368 - $488 82%
Coventry - All Plans $417 - $553 93%
Comp Results - All Plans $441 - $586 98%
Three Rivers - All Plans $441 - $586 98%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals