CMS Price Transparency Data

Blood transfusion

Facility: Highland District Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $190
Cash Discount Price: $190
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Highland District Hospital is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.42x the Medicare baseline. Located in 1275 North High Street, Hillsboro, OH.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $190 (42%)

Insurance Median: $190 (42%)

Cash: $190 (42% of Medicare)

Ins. Median: $190 (42% 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
Blue Cross Blue Shield	$76 - $288	17%
Humana	$76 - $288	17%
Medicare (plans)	$76 - $78	17%
UnitedHealthcare	$76	17%
Aetna	$78 - $193	17%
Medigold	$80	18%
Immergrun_Amish	$190	42%
Medben	$190	42%
Central_Benefits_Commercial	$214	47%
Cigna	$214	47%
Medical_Mutual_Commercial	$217	48%
Uhc_	$219	49%
Highland_County_Sheriff_Dept	$280	62%
Medicaid / KanCare	$280 - $294	62%

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 $190.
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 Highland District 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.