CMS Price Transparency Data

Blood transfusion

Facility: Memorial Health Care Systems

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $710
Cash Discount Price: $1,095
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Memorial Health Care Systems is $710. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,095. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.58x the Medicare baseline. Located in 300 North Columbia Ave, Seward, NE.

Cash / Self-Pay

$1,095

Average discount available for prompt cash payment at this facility.

Insurance Median

$710

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: $1,095 (243%)

Insurance Median: $710 (158%)

Cash: $1,095 (243% of Medicare)

Ins. Median: $710 (158% 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
Molina Mcaid-All Plans	$355 - $836	79%
Ne Total Care Mcaid-All Plans	$355 - $836	79%
UnitedHealthcare	$355 - $1,518	79%
Beshp Mcr Adv - All Plans	$375 - $883	83%
Blue Cross Blue Shield	$375 - $1,472	83%
Medica Mcare Cost	$375 - $883	83%
Medica Mcr Adv	$375 - $883	83%
Tricare	$375 - $883	83%
Wellcare Mcr Adv - All Plans	$383 - $901	85%
Phcs Ppo-All Plans	$625 - $1,472	139%
Ambetter / Centene	$632 - $1,487	140%
Medica Comm-All Other Plans	$632 - $1,487	140%
Medica Elevate	$632 - $1,487	140%
Midlands Choice-All Plans	$638 - $1,503	142%
Aetna	$645 - $1,518	143%

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 $1,095.
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 Memorial Health Care Systems 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.