CMS Price Transparency Data

Blood transfusion

Facility: Prisma Health Tuomey Hospital

Billing Code: 36430 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$468

about 1.0× the $451 Medicare rate · typically $408–$818

modeled estimate · not a bill or quote

What this hospital charges insurers

$433

About the fair price

about $35 under the fair price · 1.0× Medicare

Medicare pays $451 Fair price $468 This hospital $433 Cash price $1,531 Hospital's list price $2,355

How we calculate the fair BaseRate →

How this hospital compares to other SC hospitals

Highest price of the 9 SC hospitals we have prices for — worth calling around.

Cheapest $79 Priciest $433

Black dot = this hospital, among the 9 SC hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Blood transfusion is about $468 (about 1.0× the $451 Medicare rate). Prisma Health Tuomey Hospital charges insurers about $433, or about $1,531 in cash — about the fair price. Located in Sumter, SC.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$363 - $3,736	81%
Blue Cross Blue Shieldmajor	$298 - $1,297	66%
Aetnamajor	$433 - $1,860	96%
Cignamajor	$412 - $1,806	91%
Humanamajor	$69 - $1,766	15%
Ambetter (Centene)	$759	168%
Molina	$433	96%
WellCare	$433	96%
+ 16 smaller / regional plans	$298 - $3,736

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,531), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 36430.

Insurance Before you use insurance

Call your insurance company to confirm Prisma Health Tuomey Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 36430.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Prisma Health Tuomey Hospital

Compare: Blood transfusion at other SC hospitals

Insurance negotiated median for the same procedure, sorted lowest first.