CMS Price Transparency Data

Blood transfusion

Facility: Johnson County Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $159
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Johnson County Community Hospital is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.35x the Medicare baseline. Located in 1901 S Shady St, Mountain City, TN.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $117 (26%)
Insurance Median: $159 (35%)
Cash: $117 (26% of Medicare)
Ins. Median: $159 (35% 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 - $509 8%
Aetna $148 - $622 33%
Amerigroup $148 - $509 33%
Managed Medicaire $148 33%
Medicare (plans) $148 33%
Sentara Health $148 - $173 33%
United Mine Workers Of America $148 33%
UnitedHealthcare $148 - $616 33%
Wellcare $148 33%
Humana $150 33%
Molina Healthcare $154 - $622 34%
Cigna $155 - $246 34%
Devoted Health Plan $155 34%
Nhc Advantage $155 34%
Ambetter / Centene $163 36%
Medcost $178 39%
First Health Coventry $382 85%
Seven Corners, Inc. $509 113%
Optima Health $598 133%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 S Shady St, Mountain City, TN 37683
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals