CMS Price Transparency Data

Blood transfusion

Facility: Hillcrest Hospital Pryor

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $767
Cash Discount Price: $430
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Hillcrest Hospital Pryor is $767. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.70x the Medicare baseline. Located in 111 North Bailey Street, Pryor, OK.

Cash / Self-Pay

$430

Average discount available for prompt cash payment at this facility.

Insurance Median

$767

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: $430 (95%)

Insurance Median: $767 (170%)

Cash: $430 (95% of Medicare)

Ins. Median: $767 (170% 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
Black Lung [6055]	$358	79%
Healthcare Highways [2210]	$358 - $932	79%
Hooray Health [8000]	$358	79%
Lucent Health [6000]	$358	79%
Oncology Patient Assistance Programs [2295]	$358	79%
Oscar Insurance Company [7005]	$358	79%
Osma Health Network [2345]	$358	79%
Healthscope Benefits [2290]	$439	97%
UnitedHealthcare	$439	97%
Aetna	$630	140%
Allied Benefit Systems Inc [1030]	$630	140%
Coresource [1315]	$630	140%
Coventry Healthcare [1320]	$630	140%
Meritain Health [1655]	$630	140%
The Kempton Group Administrators [2905]	$645	143%
Beacon Health Options Behavioral Health [2890]	$889	197%
Global Health [1430]	$889	197%
Resource One Administrators [2815]	$932	207%
Universal Fidelity [2085]	$932	207%
Web Tpa [2115]	$932	207%
First Health [1375]	$1,058	235%
Medica [2910]	$1,058	235%
Multiplan [1680]	$1,058	235%
Cigna	$1,180	262%
Healthpartners [1500]	$1,180	262%
Pba [1775]	$1,180	262%
Pending Ssi [1616]	$1,434	318%

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 $430.
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 Hillcrest Hospital Pryor 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.