CMS Price Transparency Data

Blood transfusion

Facility: Ward Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $910
Cash Discount Price: $998
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Ward Memorial Hospital is $910. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $998. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.02x the Medicare baseline. Located in 406 South Gary St, Monahans, TX.

Cash / Self-Pay

$998

Average discount available for prompt cash payment at this facility.

Insurance Median

$910

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: $998 (221%)

Insurance Median: $910 (202%)

Cash: $998 (221% of Medicare)

Ins. Median: $910 (202% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 202% of the Medicare baseline (a markup of 102%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$247 - $1,085	55%
Firstcare	$247 - $300	55%
Medicare (plans)	$247 - $295	55%
Superior Healthplan	$247 - $295	55%
Cigna	$759 - $905	168%
Corecare	$910 - $1,085	202%
Texas True Choice	$975 - $1,163	216%
Unicare	$1,040 - $1,240	231%
Galaxy Health Network	$1,170 - $1,395	260%
Multiplan	$1,170 - $1,395	260%
Usa Health Network	$1,170 - $1,395	260%
Usc Health Services	$1,170 - $1,395	260%
Aetna	$1,287 - $1,535	286%

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 $998.
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 Ward Memorial Hospital 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.