CMS Price Transparency Data

Blood transfusion

Facility: Clarion Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $472
  • Cash Discount Price: $676
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Clarion Hospital is $472. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $676. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.05x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$676

Average discount available for prompt cash payment at this facility.

Insurance Median
$472

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: $676 (150%)
Insurance Median: $472 (105%)
Cash: $676 (150% of Medicare)
Ins. Median: $472 (105% 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
Medicaid / KanCare $28 6%
Amerihealth $31 - $421 7%
Jefferson Health Plan $31 7%
Geisinger $34 - $442 8%
Upmc $35 - $735 8%
Workers Comp $88 - $427 20%
Highmark $321 - $698 71%
Highmark - Ind.& Managed Care $321 - $944 71%
Martin'S Point - Usfhp $330 - $514 73%
Gateway $349 - $544 77%
Devoted Health Plan $378 - $588 84%
Highmark Community Blue $419 93%
Cigna $421 - $735 93%
Medicare (plans) $421 93%
Tricare $421 93%
UnitedHealthcare $421 93%
Aetna $433 - $1,308 96%
The Health Plan $446 - $988 99%
Pa Health & Wellness $450 100%
American Health Plan $463 103%
Peak Health $661 - $1,029 147%
Devon $708 - $1,102 157%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals