CMS Price Transparency Data

Blood transfusion

Facility: Colleton Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,535
Cash Discount Price: $2,338
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Colleton Medical Center is $1,535. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,338. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.41x the Medicare baseline. Located in 501 Robertson Boulevard, Walterboro, SC.

Cash / Self-Pay

$2,338

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,535

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: $2,338 (519%)

Insurance Median: $1,535 (341%)

Cash: $2,338 (519% of Medicare)

Ins. Median: $1,535 (341% 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 341% of the Medicare baseline (a markup of 241%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Absolute Total Care	$356 - $439	79%
Molina	$439 - $1,586	97%
Sc State Employees	$626 - $714	139%
Blue Choice Health Plan	$729 - $762	162%
Blue Cross Blue Shield	$729 - $2,316	162%
Select Health	$1,048	233%
Employers Health Network	$1,097	243%
United	$1,097 - $4,665	243%
Value Option	$1,219	270%
Vocational Rehab	$1,317	292%
Medcost	$1,375 - $1,780	305%
Aetna	$1,412	313%
Cigna	$1,575	349%
Humana	$1,585 - $2,194	352%
Mhnet	$1,828	406%
Evernorth	$1,950	433%
Multiplan	$2,072	460%
North American Administrators	$2,072	460%
Prime Health	$2,072	460%
First Health	$2,194	487%
Novanet	$2,194	487%
Apex Health	$2,550	566%
Nhc Advantage	$2,550	566%
Pruitt Health	$2,550	566%

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 $2,338.
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 Colleton 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.