CMS Price Transparency Data

Blood transfusion

Facility: The McDowell Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $511
Cash Discount Price: $1,175
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at The McDowell Hospital is $511. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,175. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.13x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$1,175

Average discount available for prompt cash payment at this facility.

Insurance Median

$511

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: $1,175 (261%)

Insurance Median: $511 (113%)

Cash: $1,175 (261% of Medicare)

Ins. Median: $511 (113% 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
Blue Cross Blue Shield	$129 - $587	29%
United	$131 - $765	29%
Wellcare	$133 - $204	30%
Amerihealth	$134 - $206	30%
Partners Health Management	$136 - $208	30%
Vaya Health	$136 - $208	30%
Cigna	$333 - $797	74%
Aetna	$357 - $1,077	79%
Oscar	$421 - $646	93%
Caresource	$427 - $655	95%
Medcost	$431 - $1,266	96%
Amerihealth Caritas	$456 - $700	101%
Magellan	$582 - $893	129%
Magellan Behavioral Health	$582 - $893	129%
Multiplan	$776 - $1,191	172%
Avalon Administrative Services	$825 - $1,266	183%
Prime Health	$854 - $1,340	189%
Apex Health	$2,550	566%
Nhc Advantage	$2,800	621%
Ambetter / Centene	$10,074	2235%

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 $1,175.
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 The McDowell 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.