CMS Price Transparency Data

Blood transfusion

Facility: Ohiohealth Morrow County Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $575
Cash Discount Price: $795
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Ohiohealth Morrow County Hospital is $575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $795. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.

Cash / Self-Pay

$795

Average discount available for prompt cash payment at this facility.

Insurance Median

$575

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: $795 (176%)

Insurance Median: $575 (128%)

Cash: $795 (176% of Medicare)

Ins. Median: $575 (128% 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
Medicaid / KanCare	$279 - $569	62%
Blue Cross Blue Shield	$378 - $1,099	84%
Medicare (plans)	$378 - $537	84%
UnitedHealthcare	$378 - $1,166	84%
Humana	$382 - $1,323	85%
Aetna	$385 - $1,224	85%
Caresource Marketplace - All Other Plans	$473 - $658	105%
Amerihealth Caritas - All Plans	$575	128%
Medical Mutual Of Ohio Marketplace	$766 - $1,067	170%
Ohiohealthy Network - All Other Plans	$766 - $1,067	170%
Ohiohealthy Preferred	$766 - $1,067	170%
Medical Mutual Of Ohio Comm - All Other Plans	$828 - $1,153	184%
Medical Mutual Of Ohio - Admin Serv	$869 - $1,210	193%
Molina Exchange - All Other Plans	$920	204%
Phcs - All Plans	$940 - $1,309	209%
Cigna	$961 - $1,338	213%
Multiplan - All Plans	$971 - $1,352	215%
Healthstar Comm - All Plans	$981 - $1,366	218%
Beech Street - All Plans	$991 - $1,380	220%

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 $795.
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 Ohiohealth Morrow County 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.