CMS Price Transparency Data

Blood transfusion

Facility: Mercy Hospital Marietta

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $654
Cash Discount Price: $1,223
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Mercy Hospital Marietta is $654. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,223. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.45x the Medicare baseline. Located in 300 Wanda Street, Marietta, OK.

Cash / Self-Pay

$1,223

Average discount available for prompt cash payment at this facility.

Insurance Median

$654

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: $1,223 (271%)

Insurance Median: $654 (145%)

Cash: $1,223 (271% of Medicare)

Ins. Median: $654 (145% 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
Blue Cross Blue Shield	$252 - $619	56%
Aetna	$326 - $1,003	72%
Cross Timbers Hospice [20098]	$326 - $466	72%
Elara Caring Aspire Hospice Contracted [320433]	$326 - $466	72%
Elara Caring Aspire Hospice [20433]	$326 - $466	72%
Halo Hcr Inc Hospice Contracted [320432]	$326 - $466	72%
Halo Hcr Inc Hospice [20432]	$326 - $466	72%
Humana	$326 - $466	72%
Independent Health [20197]	$326 - $466	72%
Indian Health Service Contracted [320198]	$326 - $466	72%
Kindful Hospice Contracted [320434]	$326 - $466	72%
Kindful Hospice [20434]	$326 - $466	72%
Medical Associates Health [20444]	$326 - $466	72%
Medicare (plans)	$326 - $489	72%
Mercy Hospice Okc [20252]	$326 - $466	72%
UnitedHealthcare	$342 - $1,007	76%
Tricare	$344 - $492	76%
Cigna	$356 - $1,079	79%
Medicaid / KanCare	$389	86%
Webtpa Contracted [320417]	$423 - $604	94%
Aither Health Contracted [320449]	$604 - $1,223	134%
Mercy Benefit Admin Contracted [320251]	$604 - $1,295	134%
Quik Trip Contracted [320447]	$604 - $863	134%
Show-Me Health Administrators Contracted [320483]	$604 - $863	134%
Osma Health Contracted [320292]	$704 - $1,007	156%
United Medical Resources Contracted [320454]	$704 - $1,295	156%
First Health Contracted [320128]	$711 - $1,017	158%
Benefit Management Contracted [320052]	$754 - $1,295	167%
Healthcare Highways Plus Contracted [320175]	$754 - $1,079	167%
Auxiant Contracted [320462]	$855 - $1,295	190%
Ebms Contracted [320493]	$855 - $1,223	190%
Healthlink Contracted [320179]	$855 - $1,295	190%
Preferred Community Choice Contracted [320311]	$855 - $1,223	190%
Federal Medical Center Contracted [320127]	$905 - $1,295	201%
Healthscope Contracted [320182]	$905 - $1,295	201%
Point C Contracted [320238]	$905 - $1,295	201%
Preferred Health Plan Contracted [320522]	$905 - $1,295	201%
Tri State Healthcare Coalition Contracted [320379]	$905 - $1,295	201%

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 $1,223.
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 Mercy Hospital Marietta 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.