CMS Price Transparency Data

Blood transfusion

Facility: Washington Hospital, The

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $408
Cash Discount Price: $387
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Washington Hospital, The is $408. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $387. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.91x the Medicare baseline. Located in 155 Wilson Avenue, Washington, PA.

Cash / Self-Pay

$387

Average discount available for prompt cash payment at this facility.

Insurance Median

$408

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: $387 (86%)

Insurance Median: $408 (91%)

Cash: $387 (86% of Medicare)

Ins. Median: $408 (91% 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
Amerihealth Caritas	$32	7%
Highmark Wholecare (Prev Gateway)	$32 - $439	7%
Aetna	$33 - $896	7%
Upmc Health Plan	$108 - $523	24%
Cigna	$190 - $922	42%
Health Plan Of Upper Ohio Valley	$215 - $1,045	48%
Peak Health	$221 - $1,076	49%
Coventry/First Health	$228 - $1,107	51%
Blue Cross Blue Shield	$388 - $961	86%
Senior Life	$417	93%
Humana	$421	93%
City Of Washington	$834	185%

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 $387.
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 Washington Hospital, The 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.