CMS Price Transparency Data

Blood transfusion

Facility: Physicians Regional Medical Center

Billing Code: 36430 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$415

about 0.9× the $451 Medicare rate · typically $202–$752

modeled estimate · not a bill or quote

What this hospital charges insurers

$414

About the fair price

about $1 under the fair price · 0.9× Medicare

Medicare pays $451 Fair price $415 This hospital $414 Cash price $552 Hospital's list price $2,490

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $67 Priciest $414

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a Blood transfusion is about $415 (about 0.9× the $451 Medicare rate). Physicians Regional Medical Center charges insurers about $414, or about $552 in cash — about the fair price. Located in Powell, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$105 - $2,634	23%
Blue Cross Blue Shieldmajor	$40 - $511	9%
Aetnamajor	$406 - $1,154	90%
Cignamajor	$918 - $923	204%
Humanamajor	$394	87%
Ambetter (Centene)	$740	164%
Amerigroup	$274 - $414	61%
Cigna HealthSpring	$406	90%
Devoted Health	$402	89%
WellCare	$416	92%
+ 7 smaller / regional plans	$394 - $740

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 552), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 36430.

Insurance Before you use insurance

Call your insurance company to confirm Physicians Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 36430.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Physicians Regional Medical Center

Compare: Blood transfusion at other TN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.