CMS Price Transparency Data

Blood transfusion

Facility: Prisma Health Hillcrest Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $446
  • Cash Discount Price: $1,531
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Prisma Health Hillcrest Hospital is $446. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,531. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.99x the Medicare baseline. Located in 741 South East Main Street, Simpsonville, SC.
Cash / Self-Pay
$1,531

Average discount available for prompt cash payment at this facility.

Insurance Median
$446

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: $1,531 (340%)
Insurance Median: $446 (99%)
Cash: $1,531 (340% of Medicare)
Ins. Median: $446 (99% 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
First Choice Benefits Mgmt [3074] $66 15%
Medicaid / KanCare $66 - $363 15%
Medicare (plans) $66 - $463 15%
Humana $70 - $431 16%
UnitedHealthcare $363 - $2,140 81%
Tricare $407 90%
Blue Cross Blue Shield $421 - $1,140 93%
Champva [3049] $421 93%
Cigna $421 - $1,634 93%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $421 93%
Deseret Mutual Ins Co [3066] $421 93%
Generic Skilled Nursing [3196] $421 93%
Hospice Contracted [1500] $421 93%
Hospice Non Contracted [3190] $421 93%
Triwest Healthcare Alliance Vcp [902] $421 93%
Va Community Care Network-Vaccn [903] $421 93%
Veterans Administration [3194] $421 93%
Aetna $442 - $1,860 98%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $442 98%
Healthy Conn Prime-First Choice Vip Care [5300] $446 99%
Healthy Conn Prime-Molina Healthcare [5330] $463 103%
Prisma Health Seniorcare Pace - Midlands [5400] $546 121%
Prisma Health Seniorcare Pace-Upstate [5200] $546 121%
Bluechoice [810] $588 - $1,203 130%
Workers Comp [600] $589 131%
Sc Dept Of Corrections [2998] $714 158%
Scdc-Sc Dept Of Corrections [7232] $714 158%
Ambetter / Centene $774 172%
Promise Health Plan Contracted [2401] $824 - $1,413 183%
Orangeburg Senior Helping Center Pace [5401] $942 209%
Planned Administrators [820] $1,140 253%
Bob Jones Univ-Pai [821] $1,413 313%
Meritain Health Contracted [2200] $1,507 - $1,860 334%
Evernorth Behavioral Contracted [2982] $1,634 363%
Mvp Health Care [3037] $1,634 363%
Preferred Administrators Contracted [2839] $1,648 366%
Medcost [2940] $1,743 - $1,955 387%
Atlantic Packaging Contracted [4833] $1,766 392%
Aps Healthcare System [2981] $1,884 418%
Multiplan/Phcs Contracted [2950] $2,096 465%
Vsp Vision Care [2986] $2,120 470%
Golden Rule Insurance Company [2991] $2,140 475%
Oxford Health Plans [2992] $2,140 475%
Zzumr-Salt Lake City Ut [3169] $2,140 475%
First Health Contracted [2952] $2,190 486%
Furman Int/Allen University Student [2951] $2,190 486%
Quiktrip-First Health [3067] $2,190 486%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 741 South East Main Street, Simpsonville, SC 29681
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals