CMS Price Transparency Data

Blood transfusion

Facility: Duncan Regional Hospital, Inc

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $2,224
  • Cash Discount Price: $891
  • vs. Medicare Baseline: 4.93x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Duncan Regional Hospital, Inc is $2,224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $891. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.93x the Medicare baseline. Located in 1407 Whisenant Drive, Duncan, OK.
Cash / Self-Pay
$891

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,224

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: $891 (198%)
Insurance Median: $2,224 (493%)
Cash: $891 (198% of Medicare)
Ins. Median: $2,224 (493% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 493% of the Medicare baseline (a markup of 393%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Humana $446 99%
Medica $1,038 230%
Healthcare Highways $1,087 - $1,606 241%
Friday Health Plan $1,136 252%
UnitedHealthcare $1,680 373%
Oklahoma Health Network (Ohn) $1,977 439%
Aetna $2,100 466%
Coventry $2,100 466%
Cigna $2,224 493%
First Health $2,224 493%
Osma Health $2,224 493%
Preferred Community Choice $2,273 504%
Healthsmart $2,323 515%
Blue Cross Blue Shield $3,503 - $5,500 777%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1407 Whisenant Drive, Duncan, OK 73533
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals