CMS Price Transparency Data

Blood transfusion

Facility: Frisbie Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $752
Cash Discount Price: $2,016
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Frisbie Memorial Hospital is $752. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,016. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.67x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$2,016

Average discount available for prompt cash payment at this facility.

Insurance Median

$752

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: $2,016 (447%)

Insurance Median: $752 (167%)

Cash: $2,016 (447% of Medicare)

Ins. Median: $752 (167% 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
Amerihealth Caritas	$104 - $189	23%
Well Sense Health Plan	$155 - $280	34%
Harvard Pilgrim	$336 - $929	75%
Maine Community Health	$361 - $1,109	80%
Cigna	$415 - $5,943	92%
Tufts Health Plan	$434 - $1,312	96%
United	$434 - $1,383	96%
Aetna	$732 - $1,326	162%
Evernorth	$1,013 - $1,835	225%
Blue Cross Blue Shield	$1,332 - $2,723	296%

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 $2,016.
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 Frisbie Memorial 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.