CMS Price Transparency Data

Blood transfusion

Facility: Punxsutawney Area Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $453
Cash Discount Price: $499
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Punxsutawney Area Hospital is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $499. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$499

Average discount available for prompt cash payment at this facility.

Insurance Median

$453

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: $499 (111%)

Insurance Median: $453 (101%)

Cash: $499 (111% of Medicare)

Ins. Median: $453 (101% 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
Highmark Wholecare	$26 - $428	6%
Amerihealth Caritas	$31 - $453	7%
UnitedHealthcare	$31 - $856	7%
Upmc Health Plan	$32 - $483	7%
Highmark	$33 - $3,183	7%
Tricare	$35 - $418	8%
Geisinger Health Plan	$37 - $462	8%
Ambetter / Centene	$38 - $485	8%
Cigna	$39 - $876	9%
Aetna	$43 - $1,013	10%
United Mine Workers Of America	$44 - $460	10%
Pa Health And Wellness Commercial	$54 - $920	12%
Geisinger	$61 - $1,289	14%
Pa Workers Compensation	$206 - $1,475	46%
Humana	$453	101%

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 $499.
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 Punxsutawney Area Hospital 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.