CMS Price Transparency Data

Blood transfusion

Facility: Adena Pike Medical Center

Billing Code: 36430 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$602

about 1.3× the $451 Medicare rate · typically $88–$1,363

modeled estimate · not a bill or quote

What this hospital charges insurers

$975

Above the fair price

about $373 over the fair price · 2.2× Medicare

Medicare pays $451 Fair price $602 This hospital $975 Cash price $765 Hospital's list price $1,530

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

Highest price of the 9 OH hospitals we have prices for — worth calling around.

Cheapest $90 Priciest $975

Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.

A fair price for a Blood transfusion is about $602 (about 1.3× the $451 Medicare rate). Adena Pike Medical Center charges insurers about $975, or about $765 in cash — above the fair price. Located in Waverly, OH.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $602. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$975 - $1,316	216%
Blue Cross Blue Shieldmajor	$367 - $1,320	81%
Aetnamajor	$367 - $1,246	81%
Cignamajor	$1,108	246%
Humanamajor	$367 - $1,454	81%
Medical Mutual	$367 - $1,153	81%
Molina	$367 - $602	81%
+ 9 smaller / regional plans	$367 - $1,438

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 765), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 36430.

Insurance Before you use insurance

Call your insurance company to confirm Adena Pike Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 36430.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Adena Pike Medical Center

Compare: Blood transfusion at other OH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.