CMS Price Transparency Data

Blood transfusion

Facility: Fairfield Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $683
Cash Discount Price: $428
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Fairfield Medical Center is $683. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $428. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.52x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$428

Average discount available for prompt cash payment at this facility.

Insurance Median

$683

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: $428 (95%)

Insurance Median: $683 (152%)

Cash: $428 (95% of Medicare)

Ins. Median: $683 (152% 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
Humana	$383 - $6,007	85%
Medical Mutual	$414 - $33,500	92%
Aetna	$419 - $6,007	93%
Blue Cross Blue Shield	$419 - $26,250	93%
Buckeye Community Health	$419 - $9,499	93%
Medicare (plans)	$419 - $6,007	93%
Medicaid / KanCare	$421	93%
Molina	$421 - $10,111	93%
UnitedHealthcare	$421 - $6,128	93%
Caresource	$425 - $7,967	94%
Medigold	$425 - $6,128	94%
Va Ccn	$425 - $6,128	94%
The Health Plan	$427 - $6,127	95%
Valor Health Plan	$427 - $6,127	95%
Amerihealth Caritas Ohio	$442	98%
Bwc	$591 - $8,512	131%
Allied Benefit Systems	$639 - $683	142%
Meritain Health	$639 - $683	142%
Quality Care Partners/Ohio Ppo Connect	$662 - $708	147%
The Ohio State Health Plan	$708 - $757	157%
Cigna	$757 - $810	168%
Oscar	$787 - $6,490	175%
Ohio Healthy	$864 - $924	192%
Multiplan	$873 - $934	194%
Miscellaneous Plans	$919 - $983	204%

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 $428.
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 Fairfield Medical Center 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.