CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital - Cassville
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $196
- Cash Discount Price: $224
- vs. Medicare Baseline: 0.43x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital - Cassville is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.43x the Medicare baseline. Located in 94 Main Street, Cassville, MO.
Cash / Self-Pay
$224
Average discount available for prompt cash payment at this facility.
Insurance Median
$196
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: $224 (50%)
Insurance Median: $196 (43%)
Cash: $224 (50% of Medicare)
Ins. Median: $196 (43% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $34 - $389 | 8% |
| Blue Cross Blue Shield | $34 - $423 | 8% |
| Cherokee Nation Health Serv Contracted [320066] | $34 - $180 | 8% |
| Cigna | $34 - $414 | 8% |
| Cross Timbers Hospice [20098] | $34 - $180 | 8% |
| Elara Caring Aspire Hospice [20433] | $34 - $180 | 8% |
| Globalhealth Contracted [320145] | $34 - $180 | 8% |
| Halo Hcr Inc Hospice Contracted [320432] | $34 - $180 | 8% |
| Halo Hcr Inc Hospice [20432] | $34 - $180 | 8% |
| Humana | $34 - $389 | 8% |
| Indian Health Service Contracted [320198] | $34 - $180 | 8% |
| Kindful Hospice Contracted [320434] | $34 - $180 | 8% |
| Kindful Hospice [20434] | $34 - $180 | 8% |
| Medical Associates Health Contracted [320444] | $34 - $180 | 8% |
| Medicare (plans) | $34 - $408 | 8% |
| Mercy Hospice Okc [20252] | $34 - $180 | 8% |
| Mercy Mgd Behavioral Health Contracted [320259] | $34 - $180 | 8% |
| Pace Of The Ozarks Contracted [320518] | $34 - $180 | 8% |
| Provider Partners Health Plans Contracted [320450] | $34 - $180 | 8% |
| Qual Choice Contracted [320325] | $34 - $180 | 8% |
| Healthscope Contracted [320182] | $35 - $182 | 8% |
| Health Systems Inc Contracted [320174] | $40 | 9% |
| Insurance System Inc Contracted [320465] | $40 | 9% |
| Medicaid / KanCare | $54 - $548 | 12% |
| Dept Of Veteran Affairs Contracted [320106] | $73 - $149 | 16% |
| Tricare | $87 - $177 | 19% |
| UnitedHealthcare | $89 - $574 | 20% |
| Administrative Payor Contracted [320005] | $97 - $196 | 22% |
| Centivo Contracted [320505] | $110 - $222 | 24% |
| Ambetter / Centene | $112 - $227 | 25% |
| Home State Health Plan Contracted [320187] | $112 - $227 | 25% |
| Novasys Contracted [320285] | $112 - $227 | 25% |
| Healthlink Contracted [320179] | $140 - $392 | 31% |
| Preferred Health Plan Contracted [320522] | $140 - $283 | 31% |
| Point C Contracted [320238] | $172 - $392 | 38% |
| Point C [20238] | $172 - $349 | 38% |
| United Medical Resources Contracted [320454] | $172 - $371 | 38% |
| Workers Comp [20426] | $172 - $392 | 38% |
| Municipal Health Plan Contracted [320271] | $174 - $353 | 39% |
| Medica Contracted [320239] | $193 - $391 | 43% |
| 90 Degree Benefits Contracted [320436] | $194 - $392 | 43% |
| Aither Health Contracted [320449] | $194 - $392 | 43% |
| American Healthcare Alliance Contracted [320020] | $194 - $392 | 43% |
| Auxiant Contracted [320462] | $194 - $392 | 43% |
| Benefit Management Contracted [320052] | $194 - $392 | 43% |
| Ebms Contracted [320493] | $194 - $392 | 43% |
| Edison Health Solutions Contracted [320502] | $194 - $392 | 43% |
| Evolutions Health Care Contracted [320124] | $194 - $392 | 43% |
| Imagine 360 Contracted [320494] | $194 - $392 | 43% |
| Mercy Benefit Admin Contracted [320251] | $194 - $392 | 43% |
| Reflect Health Contracted [320492] | $194 - $392 | 43% |
| Show-Me Health Administrators Contracted [320483] | $194 - $392 | 43% |
| Usa Managed Care Org Contracted [320429] | $194 - $392 | 43% |
| Yuzu Health Contracted [320521] | $194 - $392 | 43% |
| First Health Contracted [320128] | $204 - $414 | 45% |
| Multiplan Contracted [320270] | $204 - $414 | 45% |
| Private Health Care Systems Contracted [320320] | $204 - $414 | 45% |