CMS Price Transparency Data

Blood transfusion

Facility: St Joseph's Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $769
  • Cash Discount Price: $750
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at St Joseph's Hospital is $769. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $750. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.71x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$750

Average discount available for prompt cash payment at this facility.

Insurance Median
$769

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: $750 (166%)
Insurance Median: $769 (171%)
Cash: $750 (166% of Medicare)
Ins. Median: $769 (171% 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
Clear Spring Health of Illinois $208 46%
Blue Cross Blue Shield $208 46%
Aetna $208 - $728 46%
Humana $208 46%
Molina Healthcare $208 - $815 46%
Sae Hospice $208 46%
UnitedHealthcare $208 - $1,041 46%
Amish Community $291 65%
Caterpillar, Inc. $368 82%
Naphcare $437 97%
Celtic Insurance Company $458 102%
Claim Doc $520 115%
Hopetrust $520 115%
Wellfirst $666 148%
Cigna $697 155%
First Health $769 171%
Meridian Health Plan $853 189%
Multiplan/Phcs $885 196%
Healthlink $885 196%
Provider Network of America $937 208%
Healthcare Finest Network (Hfn) $937 208%
Current Health Solutions $1,041 231%
Mental Health Network $1,041 231%
Consociate Group $1,041 231%
Health Alliance Medical Plans $1,041 231%
Qtc Medical Group of Illinois $1,041 231%
Healthscope $1,041 231%
Interplan $1,041 231%
Illinois Breast and Cervical Cancer Program $1,041 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals