CMS Price Transparency Data

Blood transfusion

Facility: Graham Regional Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $193
Cash Discount Price: $318
vs. Medicare Baseline: 0.43x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Graham Regional Medical Center is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $318. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.43x the Medicare baseline. Located in 1301 Montgomery Road, Graham, TX.

Cash / Self-Pay

$318

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $318 (71%)

Insurance Median: $193 (43%)

Cash: $318 (71% of Medicare)

Ins. Median: $193 (43% 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
Amerigroup	$21 - $283	5%
Choicecare Network	$21 - $283	5%
Superior Healthplan	$21 - $283	5%
Wellpoint	$28 - $382	6%
Curative	$42 - $566	9%
Aetna	$46 - $613	10%
Cigna	$46 - $613	10%
Blue Cross Blue Shield	$48 - $707	11%
Three Rivers Provider Network	$60 - $802	13%
Health Advantage Network	$63 - $849	14%
Healthsmart Preferred Care	$63 - $849	14%
UnitedHealthcare	$104 - $1,910	23%

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 $318.
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 Graham Regional 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.