CMS Price Transparency Data
Blood transfusion
Facility: Prisma Health Greenville Memorial Hospital
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $427
- Cash Discount Price: $1,531
- vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Prisma Health Greenville Memorial Hospital is $427. 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 0.95x the Medicare baseline. Located in 701 Grove Road, Greenville, SC.
Cash / Self-Pay
$1,531
Average discount available for prompt cash payment at this facility.
Insurance Median
$427
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: $427 (95%)
Cash: $1,531 (340% of Medicare)
Ins. Median: $427 (95% 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
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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] | $78 | 17% |
| Medicaid / KanCare | $78 - $363 | 17% |
| Medicare (plans) | $78 - $460 | 17% |
| Humana | $94 - $435 | 21% |
| Aetna | $167 - $1,860 | 37% |
| Blue Cross Blue Shield | $167 - $1,267 | 37% |
| Champva [3049] | $167 - $418 | 37% |
| Cigna | $167 - $1,634 | 37% |
| Covid19 Hrsa Uninsured Testing & Treatment Fund [904] | $167 - $418 | 37% |
| Deseret Mutual Ins Co [3066] | $167 - $418 | 37% |
| Generic Skilled Nursing [3196] | $167 - $418 | 37% |
| Healthy Conn Prime-Wellcare Prime By Atc [5310] | $167 - $439 | 37% |
| Hospice Contracted [1500] | $167 - $418 | 37% |
| Hospice Non Contracted [3190] | $167 - $418 | 37% |
| Triwest Healthcare Alliance Vcp [902] | $167 - $418 | 37% |
| UnitedHealthcare | $167 - $2,140 | 37% |
| Va Community Care Network-Vaccn [903] | $167 - $418 | 37% |
| Veterans Administration [3194] | $167 - $418 | 37% |
| Workers Comp [600] | $167 - $586 | 37% |
| Ambetter / Centene | $308 - $770 | 68% |
| Tricare | $407 | 90% |
| Healthy Conn Prime-First Choice Vip Care [5300] | $443 | 98% |
| Healthy Conn Prime-Molina Healthcare [5330] | $460 | 102% |
| Prisma Health Seniorcare Pace - Midlands [5400] | $546 | 121% |
| Prisma Health Seniorcare Pace-Upstate [5200] | $546 | 121% |
| Bluechoice [810] | $602 - $1,335 | 134% |
| Scdc-Sc Dept Of Corrections [7232] | $714 | 158% |
| Promise Health Plan Contracted [2401] | $824 - $1,413 | 183% |
| Orangeburg Senior Helping Center Pace [5401] | $942 | 209% |
| Planned Administrators [820] | $1,267 | 281% |
| Bob Jones Univ-Pai [821] | $1,413 | 313% |
| Magellan Behavioral Contracted [3198] | $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% |