CMS Price Transparency Data

Blood transfusion

Facility: Excela Health - Frick Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $476
  • Cash Discount Price: $390
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Excela Health - Frick Hospital is $476. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.06x the Medicare baseline. Located in 508 South Church Street, Mount Pleasant, PA.
Cash / Self-Pay
$390

Average discount available for prompt cash payment at this facility.

Insurance Median
$476

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: $390 (87%)
Insurance Median: $476 (106%)
Cash: $390 (87% of Medicare)
Ins. Median: $476 (106% 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
Geisinger $33 - $473 7%
Health Partners Plans $33 7%
Highmark Wholecare $34 - $491 8%
Upmc $35 - $487 8%
Amerihealth Caritas $36 - $473 8%
Pa Health And Wellness $36 - $482 8%
Upmc For Kids Chip $72 16%
Upmc Health Plan $315 - $523 70%
Highmark Advantage Community Blue $419 93%
Senior Life $451 100%
Va $451 100%
Aetna $464 - $1,037 103%
Health Partners Plan $464 103%
Martin'S Point $464 103%
Peak Health $464 - $1,059 103%
Humana $469 104%
United $469 104%
Cigna $473 - $995 105%
Devoted $473 105%
The Health Plan Of West Virginia $478 - $1,059 106%
American Health Plan Of Pa $496 110%
Provider Network Of America $496 - $520 110%
Provider Plan Partners Plan $496 110%
Highmark Children'S Health Insurance Program $542 120%
Ambetter / Centene $563 125%
Highmark $610 - $995 135%
Velocity $676 150%
Community Blue $895 199%
UnitedHealthcare $1,149 255%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 508 South Church Street, Mount Pleasant, PA 15666
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals