CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital Ada
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $445
- Cash Discount Price: $829
- vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Ada is $445. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $829. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.99x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$829
Average discount available for prompt cash payment at this facility.
Insurance Median
$445
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: $829 (184%)
Insurance Median: $445 (99%)
Cash: $829 (184% of Medicare)
Ins. Median: $445 (99% 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.
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 | $38 - $437 | 8% |
| Healthcare Highways Plus Contracted [320175] | $257 - $957 | 57% |
| Webtpa Contracted [320417] | $276 - $536 | 61% |
| Osma Health Contracted [320292] | $296 - $574 | 66% |
| UnitedHealthcare | $303 - $893 | 67% |
| Medica Contracted [320239] | $307 - $1,276 | 68% |
| Benefit Management Contracted [320052] | $329 - $829 | 73% |
| Aetna | $389 - $960 | 86% |
| Humana | $389 - $445 | 86% |
| Medicaid / KanCare | $389 - $601 | 86% |
| Aither Health Contracted [320449] | $395 - $766 | 88% |
| Auxiant Contracted [320462] | $395 - $766 | 88% |
| Ebms Contracted [320493] | $395 - $766 | 88% |
| Federal Medical Center Contracted [320127] | $395 - $766 | 88% |
| Healthlink Contracted [320179] | $395 - $766 | 88% |
| Healthscope Contracted [320182] | $395 - $766 | 88% |
| Imagine 360 Contracted [320494] | $395 - $766 | 88% |
| Mercy Benefit Admin Contracted [320251] | $395 - $829 | 88% |
| Point C Contracted [320238] | $395 - $766 | 88% |
| Preferred Health Plan Contracted [320522] | $395 - $766 | 88% |
| Quik Trip Contracted [320447] | $395 - $766 | 88% |
| Reflect Health Contracted [320492] | $395 - $766 | 88% |
| Show-Me Health Administrators Contracted [320483] | $395 - $766 | 88% |
| United Medical Resources Contracted [320454] | $395 - $893 | 88% |
| Workers Comp [20426] | $395 - $766 | 88% |
| Yuzu Health Contracted [320521] | $395 - $766 | 88% |
| Globalhealth Contracted [320144] | $415 - $804 | 92% |
| Cherokee Nation Health Serv Contracted [320066] | $437 | 97% |
| Cross Timbers Hospice [20098] | $437 | 97% |
| Dept Of Veteran Affairs Contracted [320106] | $437 | 97% |
| Elara Caring Aspire Hospice Contracted [320433] | $437 | 97% |
| Elara Caring Aspire Hospice [20433] | $437 | 97% |
| Halo Hcr Inc Hospice Contracted [320432] | $437 | 97% |
| Halo Hcr Inc Hospice [20432] | $437 | 97% |
| Independent Health [20197] | $437 | 97% |
| Indian Health Service Contracted [320198] | $437 | 97% |
| Kindful Hospice Contracted [320434] | $437 | 97% |
| Kindful Hospice [20434] | $437 | 97% |
| Medical Associates Health [20444] | $437 | 97% |
| Medicare (plans) | $437 - $1,276 | 97% |
| Mercy Hospice Okc [20252] | $437 | 97% |
| Provider Partners Health Plans Contracted [320450] | $437 | 97% |
| Qual Choice Contracted [320325] | $437 | 97% |
| Tricare | $437 | 97% |
| Globalhealth Contracted [320145] | $446 | 99% |
| Cigna | $450 | 100% |
| First Health Contracted [320128] | $547 - $1,060 | 121% |
| Multiplan Contracted [320270] | $559 - $1,085 | 124% |
| Private Health Care Systems Contracted [320320] | $559 - $1,085 | 124% |
| Ambetter / Centene | $601 | 133% |
| Home State Health Plan Contracted [320187] | $601 | 133% |
| Novasys Contracted [320285] | $601 | 133% |
| Health Choice Contracted [320166] | $874 | 194% |
| Healthsmart Preferred Care Contracted [320184] | $983 | 218% |
| Kempton Contracted [320214] | $983 | 218% |