CMS Price Transparency Data

Blood transfusion

Facility: Erlanger Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $73
Cash Discount Price: $1,219
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Erlanger Medical Center is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,219. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.16x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$1,219

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $1,219 (270%)

Insurance Median: $73 (16%)

Cash: $1,219 (270% of Medicare)

Ins. Median: $73 (16% 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
Humana	$27 - $1,385	6%
UnitedHealthcare	$27 - $781	6%
Bluecare	$31 - $620	7%
Cigna	$32 - $1,159	7%
Amerigroup	$34 - $483	8%
Caresource	$34 - $802	8%
Peach State Hlth Plan	$34	8%
Blue Cross Blue Shield	$35 - $1,846	8%
Alexian	$55 - $371	12%
Clover	$55 - $401	12%
Medicare (plans)	$55	12%
Upmc	$55 - $401	12%
Aetna	$56 - $1,131	12%
American Health	$57 - $413	13%
Pruitthealth Premier	$57	13%
Devoted Health	$58 - $417	13%
Nhc	$58 - $421	13%
Atrio Health	$61 - $441	14%
Simpra Advantage	$61	14%
Ambetter / Centene	$69 - $501	15%
Pnoa	$70 - $1,003	16%
Olympus	$83 - $1,731	18%
Caresource Ga	$85 - $153	19%
Caresource Tn	$85 - $153	19%
Alliant	$88 - $1,731	20%
Occunet	$97 - $381	22%
Point Comfort Underwriters	$97 - $100	22%
Caresource Nc	$103 - $153	23%
Wellpoint	$383	85%
First Health	$1,846 - $1,962	410%

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 $1,219.
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 Erlanger Medical Center 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.