CMS Price Transparency Data

Blood transfusion

Facility: Jackson-Madison County General Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $412
Cash Discount Price: $209
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Jackson-Madison County General Hospital is $412. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.91x the Medicare baseline. Located in 620 Skyline Drive, Jackson, TN.

Cash / Self-Pay

$209

Average discount available for prompt cash payment at this facility.

Insurance Median

$412

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: $209 (46%)

Insurance Median: $412 (91%)

Cash: $209 (46% of Medicare)

Ins. Median: $412 (91% 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
Blue Cross Blue Shield	$85 - $412	19%
River Valley Plan	$193	43%
Aetna	$341 - $447	76%
Choicecare	$400 - $697	89%
Veterans Affairs	$400	89%
Cigna	$403	89%
Celtic Insurance Company	$620	138%
Oscar	$678	150%

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 $209.
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 Jackson-Madison County General Hospital 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.