CMS Price Transparency Data

Blood transfusion

Facility: Fostoria Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $658
Cash Discount Price: $807
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Fostoria Community Hospital is $658. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $807. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.46x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$807

Average discount available for prompt cash payment at this facility.

Insurance Median

$658

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: $807 (179%)

Insurance Median: $658 (146%)

Cash: $807 (179% of Medicare)

Ins. Median: $658 (146% 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
Buckeye Community Health Plan	$27 - $675	6%
Dayton Area Health Plan Dba Caresource	$28 - $662	6%
UnitedHealthcare	$28 - $743	6%
Paramount Health Care	$42 - $658	9%
Blue Cross Blue Shield	$43 - $1,906	10%
Health Alliance Plan	$43 - $932	10%
Health Value Management	$43 - $269	10%
Aetna	$49 - $832	11%
Buckeye Community Health Plan Inc	$49 - $451	11%
Meridian Health Plan Of Mi	$242	54%
Veterans Affairs	$273	61%
Amerihealth	$700	155%
Medical Mutual Of Ohio	$702 - $746	156%
Frontpath Health Coalition	$715	159%
Ohio Health Choice	$807	179%
Ohio Ppo Connect	$807 - $932	179%
Health Ohio Network	$981	218%
Connecticut General Life Insurance Company	$991	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 $807.
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 Fostoria Community 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.