CMS Price Transparency Data

Blood transfusion

Facility: Lancaster General Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $1,180
  • Cash Discount Price: $2,025
  • vs. Medicare Baseline: 2.62x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Lancaster General Hospital is $1,180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,025. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.62x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$2,025

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,180

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: $2,025 (449%)
Insurance Median: $1,180 (262%)
Cash: $2,025 (449% of Medicare)
Ins. Median: $1,180 (262% 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 262% of the Medicare baseline (a markup of 162%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 - $874 6%
Gateway $33 7%
Upmc For You $47 10%
Hospice And Community Care $385 85%
Tricare $403 89%
Highmark $444 - $2,025 99%
Albright Life $448 99%
Coatesville Va $448 99%
Hospice Generic $448 99%
Lebanon Veterans Hospital $448 99%
Medicare (plans) $448 - $496 99%
UnitedHealthcare $448 - $1,721 99%
Aetna $453 - $1,371 101%
Blue Cross Blue Shield $455 - $5,296 101%
Amerihealth Caritas $457 101%
Cigna $462 - $1,694 103%
Health Partners Mcr Advantage $462 103%
Devoted Health $471 104%
Pa Health And Wellness Mcr $471 104%
Old Order Group $547 - $648 121%
Lg Coresource/Lg Eliance $577 128%
Lancashire Hall $608 - $2,025 135%
Nursing Home Op Services $608 135%
Elap Employees $636 141%
Affilia Home Health $810 - $2,025 180%
Masonic Homes $850 - $2,025 189%
Oscar Health Plan $874 194%
Eliance Health Solutions $1,296 288%
Claim Watcher Plus $1,345 298%
Highmark Commercial Preferred $1,355 - $2,025 301%
Claim Watcher $1,479 328%
Elap Other Groups $1,631 362%
Ehp $1,660 368%
Upmc Commercial $1,660 - $1,721 368%
Devon $1,721 382%
Geisinger Commercial $1,721 382%
Intergroup Services $1,721 382%
Preferred Healthcare $1,721 382%
Medi-Share Christian Care $1,924 427%
Commercial Generic $2,025 449%
Highmark Commercial Non-Preferred $2,025 - $2,042 449%
Magellan $2,025 449%
United Behavioral Health $2,025 449%
Value Options $2,025 449%
Workers Compensation $2,025 449%
Gift Of Life Donor Program $13,500 2995%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals