CMS Price Transparency Data

Blood transfusion

Facility: UPMC Williamsport

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,448
Cash Discount Price: $1,821
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at UPMC Williamsport is $1,448. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,821. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.21x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$1,821

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,448

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: $1,821 (404%)

Insurance Median: $1,448 (321%)

Cash: $1,821 (404% of Medicare)

Ins. Median: $1,448 (321% 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 321% of the Medicare baseline (a markup of 221%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$31 - $429	7%
Geisinger	$31 - $2,033	7%
Upmc Health Plan	$31 - $1,323	7%
Highmark Wholecare (Prev Gateway)	$39 - $450	9%
Pa Health & Wellness	$47 - $450	10%
Upmc Work Partners	$79	18%
Three Rivers Provider Network	$85 - $2,732	19%
Multiplan	$88 - $2,367	20%
Blue Cross Blue Shield	$421 - $1,422	93%
Aetna	$429 - $2,003	95%
UnitedHealthcare	$446 - $2,076	99%
Coventry/First Health	$1,521 - $2,043	337%
Wirerope Works	$1,687	374%
Cigna	$2,079	461%
America'S Choice	$2,428	539%
Intergroup	$2,428	539%

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 $1,821.
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 UPMC Williamsport 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.