CMS Price Transparency Data

Blood transfusion

Facility: Memorial Hospital of Carbon County

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $600
Cash Discount Price: $602
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Memorial Hospital of Carbon County is $600. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $602. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.33x the Medicare baseline. Located in 2221 West Elm Street, Rawlins, WY.

Cash / Self-Pay

$602

Average discount available for prompt cash payment at this facility.

Insurance Median

$600

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: $602 (134%)

Insurance Median: $600 (133%)

Cash: $602 (134% of Medicare)

Ins. Median: $600 (133% 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
Blue Cross Blue Shield	$323 - $903	72%
Medicare (plans)	$323 - $511	72%
Vaccn	$323 - $511	72%
Three_River_Providers_Network	$466 - $736	103%
Wise_Provider_Networks	$466 - $736	103%
Zelis	$466 - $736	103%
Corechoice	$560 - $884	124%
First_Choice_Health	$560 - $884	124%
Cigna	$578 - $913	128%
UnitedHealthcare	$597 - $943	132%
Interwests_Ppo_Network	$603 - $953	134%
Multiplan	$603 - $953	134%
Medicaid / KanCare	$622 - $982	138%

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 $602.
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 Memorial Hospital of Carbon County 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.