CMS Price Transparency Data
Blood transfusion
Facility: Mercy Hospital Watonga, Inc
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $395
- Cash Discount Price: $1,745
- vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Watonga, Inc is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,745. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.88x the Medicare baseline. Located in 500 North Clarence Nash Boulevard, Watonga, OK.
Cash / Self-Pay
$1,745
Average discount available for prompt cash payment at this facility.
Insurance Median
$395
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: $1,745 (387%)
Insurance Median: $395 (88%)
Cash: $1,745 (387% of Medicare)
Ins. Median: $395 (88% 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 | $204 - $282 | 45% |
| Ambetter / Centene | $212 | 47% |
| Home State Health Plan Contracted [320187] | $212 | 47% |
| Medicaid / KanCare | $212 - $389 | 47% |
| Novasys Contracted [320285] | $212 | 47% |
| Aetna | $270 - $537 | 60% |
| Cherokee Nation Health Serv Contracted [320066] | $270 | 60% |
| Cross Timbers Hospice [20098] | $270 | 60% |
| Dept Of Veteran Affairs Contracted [320106] | $270 | 60% |
| Elara Caring Aspire Hospice Contracted [320433] | $270 | 60% |
| Elara Caring Aspire Hospice [20433] | $270 | 60% |
| Halo Hcr Inc Hospice Contracted [320432] | $270 | 60% |
| Halo Hcr Inc Hospice [20432] | $270 | 60% |
| Humana | $270 - $389 | 60% |
| Independent Health [20197] | $270 | 60% |
| Indian Health Service Contracted [320198] | $270 | 60% |
| Kindful Hospice Contracted [320434] | $270 | 60% |
| Kindful Hospice [20434] | $270 | 60% |
| Medical Associates Health [20444] | $270 | 60% |
| Medicare (plans) | $270 - $395 | 60% |
| Mercy Hospice Okc [20252] | $270 | 60% |
| Provider Partners Health Plans Contracted [320450] | $270 | 60% |
| Qual Choice Contracted [320325] | $270 | 60% |
| Tribute Health Plan Mcr Contracted [320338] | $270 | 60% |
| Tricare | $270 | 60% |
| UnitedHealthcare | $270 - $558 | 60% |
| Globalhealth Contracted [320145] | $275 | 61% |
| Cigna | $278 - $599 | 62% |
| Webtpa Contracted [320417] | $296 | 66% |
| Medica Contracted [320239] | $395 | 88% |
| Aither Health Contracted [320449] | $423 - $599 | 94% |
| Mercy Benefit Admin Contracted [320251] | $423 - $599 | 94% |
| Quik Trip Contracted [320447] | $423 | 94% |
| Show-Me Health Administrators Contracted [320483] | $423 | 94% |
| Benefit Management Contracted [320052] | $458 - $529 | 102% |
| Healthsmart Accel Contracted [320183] | $494 | 110% |
| Osma Health Contracted [320292] | $494 | 110% |
| Healthcare Highways Plus Contracted [320175] | $529 | 117% |
| Preferred Community Choice Contracted [320311] | $529 | 117% |
| Private Health Care Systems Contracted [320320] | $529 - $564 | 117% |
| United Medical Resources Contracted [320454] | $558 | 124% |
| Multiplan Contracted [320270] | $564 - $634 | 125% |
| First Health Contracted [320128] | $572 | 127% |
| Auxiant Contracted [320462] | $599 | 133% |
| Ebms Contracted [320493] | $599 | 133% |
| Healthlink Contracted [320179] | $599 | 133% |
| Healthsmart Preferred Care Contracted [320184] | $599 | 133% |
| Imagine 360 Contracted [320494] | $599 | 133% |
| Reflect Health Contracted [320492] | $599 | 133% |
| Yuzu Health Contracted [320521] | $599 | 133% |
| Health Choice Contracted [320166] | $874 | 194% |