CMS Price Transparency Data

Blood transfusion

Facility: UPMC Hanover

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $668
Cash Discount Price: $1,476
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at UPMC Hanover is $668. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,476. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.48x the Medicare baseline. Located in 300 Highland Ave, Hanover, PA.

Cash / Self-Pay

$1,476

Average discount available for prompt cash payment at this facility.

Insurance Median

$668

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: $1,476 (327%)

Insurance Median: $668 (148%)

Cash: $1,476 (327% of Medicare)

Ins. Median: $668 (148% 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
Amerihealth Caritas	$35	8%
Highmark Wholecare (Prev Gateway)	$35	8%
Upmc Health Plan	$36 - $1,722	8%
Health Partners Plans (Jefferson Health Plan)	$38	8%
Geisinger	$41 - $1,777	9%
Pa Health & Wellness	$47 - $451	10%
Upmc Work Partners	$80	18%
UnitedHealthcare	$202 - $1,017	45%
Blue Cross Blue Shield	$413 - $1,672	92%
Humana	$418	93%
Aetna	$436 - $1,791	97%
Cigna	$439 - $1,919	97%
Keystone Health Plan	$467 - $1,672	104%
Prime Net	$595 - $768	132%
Keystone Autism Services	$668	148%
Carefirst	$2,091	464%
Multiplan	$2,091	464%
Wellspan Population Health	$2,140	475%

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 $1,476.
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 Hanover 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.