CMS Price Transparency Data

Blood transfusion

Facility: Physicians Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $416
  • Cash Discount Price: $552
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Physicians Regional Medical Center is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $552. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.92x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$552

Average discount available for prompt cash payment at this facility.

Insurance Median
$416

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: $552 (122%)
Insurance Median: $416 (92%)
Cash: $552 (122% of Medicare)
Ins. Median: $416 (92% 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
Veterans Eval Services $37 8%
Blue Cross Blue Shield $40 - $511 9%
UnitedHealthcare $105 - $2,634 23%
Medicaid / KanCare $142 32%
Amerigroup $274 - $414 61%
Amerigroup Community Care $274 61%
Tricare $380 84%
Humana $394 87%
Medicare (plans) $394 87%
Node Bluecare Plus Tn Mcr Adv $394 - $400 87%
Department Of Veterans Affairs $400 89%
Node Hospice Non Par Agree $400 89%
Node Va $400 89%
Node Devoted Health Mcr Adv $402 89%
Node Farm Bureau Mcr Adv $402 89%
Aetna $406 - $1,154 90%
Node Healthspring Mcr Adv $406 90%
Wellcare $416 92%
Node Nhc Mcr Adv $433 96%
Node Us Dept Of Labor $500 111%
Us Department Of Labor $500 111%
Self Pay $510 - $597 113%
Novanet Work Comp Tn $649 144%
Occunet Work Comp Tn $656 146%
Tn Work Comp $656 146%
Ambetter / Centene $740 164%
Node Point Comfort Underwriters $740 164%
Cigna $918 - $923 204%
Multiplan $1,267 - $1,870 281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals