CMS Price Transparency Data

Blood transfusion

Facility: Lincoln Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,055
Cash Discount Price: $1,190
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Lincoln Hospital is $1,055. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,190. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.34x the Medicare baseline. Located in 10 Nichols Street, Davenport, WA.

Cash / Self-Pay

$1,190

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,055

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: $1,190 (264%)

Insurance Median: $1,055 (234%)

Cash: $1,190 (264% of Medicare)

Ins. Median: $1,055 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Labor & Industries - All Plans	$80	18%
Ambetter / Centene	$619	137%
Molina Hlthy Options	$619	137%
UnitedHealthcare	$619 - $1,164	137%
Amerigroup Mcaid - All Plans	$656	146%
Aetna	$741 - $1,257	164%
Indian Hlth Services - All Plans	$741	164%
Tricare	$741	164%
Va Ccn - All Plans	$741	164%
Cigna	$1,009	224%
Molina Exchange-All Other Plans	$1,052	233%
Focus Healthcare Mgmt - All Plans	$1,058	235%
Blue Cross Blue Shield	$1,164	258%
Uniform Medical Plan-All Plans	$1,164	258%
First Health Coventry-All Plans	$1,177	261%
Health Management Network-All Plans	$1,190	264%
Three Rivers-All Plans	$1,190	264%
Asuris Nw Health-All Plans	$1,217	270%
Multiplan-All Plans	$1,257	279%
Physician Hosp Comm Org-All Plans	$1,257	279%
First Choice Health- All Plans	$1,283	285%

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 $1,190.
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 Lincoln 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.