CMS Price Transparency Data

Blood transfusion

Facility: Johnson City Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $412
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Johnson City Medical Center is $412. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.91x the Medicare baseline. Located in 400 N State of Franklin Rd, Johnson City, TN.
Cash / Self-Pay
$119

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: $119 (26%)
Insurance Median: $412 (91%)
Cash: $119 (26% 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.

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 $36 - $568 8%
UnitedHealthcare $268 - $568 59%
Sentara Health $278 - $412 62%
Medcost $279 62%
Cigna $309 - $432 69%
Amerigroup $356 - $412 79%
Aetna $412 - $573 91%
Humana $412 91%
Managed Medicaire $412 91%
Medicare (plans) $412 91%
Mountain Empire Pace $412 91%
United Mine Workers Of America $412 91%
Molina Healthcare $428 - $573 95%
Devoted Health Plan $432 96%
Nhc Advantage $432 96%
Wellcare $436 - $796 97%
Optima Health $551 122%
First Health Coventry $597 132%
Seven Corners, Inc. $796 177%
Ambetter / Centene $897 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N State of Franklin Rd, Johnson City, TN 37604
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals