CMS Price Transparency Data

Blood transfusion

Facility: St Francis Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,685
Cash Discount Price: $1,513
vs. Medicare Baseline: 3.74x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at St Francis Hospital is $1,685. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,513. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.74x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$1,513

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,685

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: $1,513 (336%)

Insurance Median: $1,685 (374%)

Cash: $1,513 (336% of Medicare)

Ins. Median: $1,685 (374% 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 374% of the Medicare baseline (a markup of 274%). 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
Clear Spring Health of Illinois	$441	98%
Humana	$441	98%
Blue Cross Blue Shield	$441 - $483	98%
UnitedHealthcare	$462 - $2,101	103%
Aetna	$462 - $1,477	103%
Molina Healthcare	$463 - $526	103%
Wexford	$501	111%
Meridian Health Plan	$551	122%
Amish Community	$588	130%
Celtic Insurance Company	$1,063	236%
Claim Doc	$1,103	245%
Hopetrust	$1,208	268%
Wellfirst	$1,352	300%
First Health	$1,559	346%
Caterpillar, Inc.	$1,685	374%
Current Health Solutions	$1,765	392%
Consociate Group	$1,786	396%
Multiplan/Phcs	$1,786	396%
Healthlink	$1,792	398%
Cigna	$1,870	415%
Provider Network of America	$1,891	420%
Healthcare Finest Network (Hfn)	$1,891	420%
Health Alliance Medical Plans	$2,101	466%
Illinois Breast and Cervical Cancer Program	$2,101	466%
Live360	$2,101	466%
Interplan	$2,101	466%
Healthscope	$2,101	466%
Naphcare	$2,101	466%

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 $1,513.
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 St Francis 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.