CMS Price Transparency Data

Blood transfusion

Facility: Harlan County Health System

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $745
Cash Discount Price: $627
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Harlan County Health System is $745. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $627. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.65x the Medicare baseline. Located in 717 Brown St, Alma, NE.

Cash / Self-Pay

$627

Average discount available for prompt cash payment at this facility.

Insurance Median

$745

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: $627 (139%)

Insurance Median: $745 (165%)

Cash: $627 (139% of Medicare)

Ins. Median: $745 (165% 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
Medica Mcr Adv	$423 - $453	94%
Medica Prime Solution	$423 - $453	94%
Humana	$525 - $561	116%
Tricare	$525 - $561	116%
Aetna	$549 - $587	122%
Great Plains Mcr Adv-All Plans	$552 - $590	122%
Medica Chi Aco - All Other Plans	$713 - $763	158%
Medica Chi Health	$713 - $763	158%
Medica Choice	$713 - $763	158%
Blue Cross Blue Shield	$745 - $804	165%
Ohara Llc Wc- All Plans	$745 - $796	165%
Medica Ifb Aco	$753 - $804	167%
Medica Ifb Open Access	$753 - $804	167%
UnitedHealthcare	$753 - $804	167%
Phcs/Multiplan-All Plans	$768 - $821	170%

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 $627.
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 Harlan County Health System 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.