CMS Price Transparency Data

Blood transfusion

Facility: Penn State Health Hampden Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $492
Cash Discount Price: $894
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Penn State Health Hampden Medical Center is $492. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $894. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.09x the Medicare baseline. Located in 2200 Good Hope Road, Enola, PA.

Cash / Self-Pay

$894

Average discount available for prompt cash payment at this facility.

Insurance Median

$492

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: $894 (198%)

Insurance Median: $492 (109%)

Cash: $894 (198% of Medicare)

Ins. Median: $492 (109% 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]	$366 - $431	81%
[Highmark Wholecare]	$366 - $431	81%
[Geisinger]	$388 - $1,897	86%
[Health Partners Plans]	$401 - $440	89%
[Pa Health & Wellness]	$403 - $444	89%
[Highmark]	$427 - $1,843	95%
UnitedHealthcare	$431 - $1,773	96%
[Cbc]	$431 - $1,420	96%
Aetna	$435 - $1,708	97%
Humana	$435	97%
[Healthspring]	$435	97%
[Upmc]	$440 - $2,100	98%
[Point Comfort Underwriters]	$539	120%
[Highmark Choice Blue]	$1,474	327%
[Highmark Aca]	$1,548	343%
Cigna	$1,744	387%
[Preferred Healthcare Systems]	$2,132	473%
[First Health]	$2,274	505%
[Multiplan]	$2,274	505%

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 $894.
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 Penn State Health Hampden Medical Center 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.