CMS Price Transparency Data

Blood transfusion

Facility: Pawhuska Hospital, Inc

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $662
Cash Discount Price: $374
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Pawhuska Hospital, Inc is $662. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $374. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.47x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$374

Average discount available for prompt cash payment at this facility.

Insurance Median

$662

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: $374 (83%)

Insurance Median: $662 (147%)

Cash: $374 (83% of Medicare)

Ins. Median: $662 (147% 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	$78 - $970	17%
Aetna	$87 - $1,141	19%
Tricare	$87 - $662	19%
UnitedHealthcare	$87 - $821	19%
Wellcare Mcr Adv - All Plans	$87 - $662	19%
Humana	$88 - $1,141	20%
Healthcare Highways - All Plans	$98 - $741	22%
Cigna	$102 - $776	23%
Multiplan - All Plans	$112 - $856	25%
Ambetter / Centene	$130 - $992	29%
Preferred Commchoice Ip/Op Only - All Plans	$135 - $1,027	30%
Soonerselect Mcaid - All Plans	$150 - $1,141	33%
Healthchoice Ip/Op Only - All Plans	$776	172%
Community Care Comm - All Plans	$1,127	250%

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 $374.
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 Pawhuska Hospital, Inc 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.