Blood transfusion
Facility: Physicians Care Surgical Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $1,364
- Cash Discount Price: $195
- vs. Medicare Baseline: 3.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $73 - $39,683 | 16% |
| Shenandoah Life | $244 | 54% |
| Personal Choice 65 | $244 - $39,683 | 54% |
| Pcsh Aarp | $244 | 54% |
| Humana | $244 | 54% |
| Tricare | $244 | 54% |
| UnitedHealthcare | $244 - $518 | 54% |
| Ibc Security 65 | $244 - $39,683 | 54% |
| Blue Cross Blue Shield | $244 - $77,820 | 54% |
| Unified Health Services | $244 | 54% |
| Gpm Health and Life Insurance Mc Supplement | $244 | 54% |
| Cigna | $244 - $61,683 | 54% |
| Aetna | $244 - $88,122 | 54% |
| Aarp | $244 | 54% |
| Keystone 65 HMO | $244 | 54% |
| Vibra Health Plan | $244 | 54% |
| Devon Health Services | $244 | 54% |
| Ibc Local | $264 - $60,191 | 59% |
| Horizon of New Jersey | $264 - $60,191 | 59% |
| Pcsh Ibc | $264 - $60,191 | 59% |
| Independence Bc | $264 - $60,191 | 59% |
| Amerihealth Administrators | $264 - $60,191 | 59% |
| Empire Plan | $264 - $60,191 | 59% |
| Personal Choice | $264 - $60,191 | 59% |
| Keystone Direct POS | $264 - $60,191 | 59% |
| Ibc - Local | $264 - $60,191 | 59% |
| Ibc | $264 - $60,191 | 59% |
| Amerihealth New Jersey HMO | $264 - $60,191 | 59% |
| Regence Blue Shield | $264 - $60,191 | 59% |
| Keystone Healthplan East | $264 - $60,191 | 59% |
| Independence Administrators | $264 - $60,191 | 59% |
| Carefirst Administrators | $264 - $60,191 | 59% |
| Independence Federal | $264 - $60,191 | 59% |
| Ibc 2021 | $264 - $60,191 | 59% |
| Keystone HMO | $264 - $60,191 | 59% |
| Connecticare | $421 - $73,145 | 93% |
| Golden Rule Op | $518 | 115% |
| Oxford Health Plan | $518 | 115% |
| Surest | $518 | 115% |
| Allsavers | $518 | 115% |
| Oxford Life Insurance Company | $518 | 115% |
| Highmark | $766 - $77,820 | 170% |
| Keystone First Vip Choice | $900 - $2,850 | 200% |
| Straight Access | $900 - $2,850 | 200% |
| Keystone First Healthplan | $900 - $2,850 | 200% |
| PA Health and Wellness | $900 - $2,850 | 200% |
| Keystone First | $900 - $2,850 | 200% |
| Medicaid / KanCare | $900 - $2,850 | 200% |
| UPMC | $1,273 - $61,448 | 282% |
| Sana Benefits | $1,364 - $61,683 | 303% |
| Loomis | $1,364 - $61,683 | 303% |
| Health Partners | $1,364 - $61,683 | 303% |
| Freedom Life Insurance Company | $1,364 - $61,683 | 303% |
| Cwi Benefits | $1,364 - $61,683 | 303% |
| Healthgram | $1,364 - $61,683 | 303% |
| Apwu | $1,364 - $61,683 | 303% |
| Nalc Health | $1,364 - $61,683 | 303% |
| Central PA Teamsters | $1,593 - $67,612 | 353% |
| Ag Administrators Inc | $1,641 - $88,122 | 364% |
| Lucent Health | $1,641 - $88,122 | 364% |
| Healthez | $1,641 - $88,122 | 364% |
| Meritain Health | $1,641 - $88,122 | 364% |
| Premier Care Network | $1,641 - $88,122 | 364% |
| Marpai Health | $1,641 - $88,122 | 364% |
| Ag Administrators | $1,641 - $88,122 | 364% |
| Geha | $1,641 - $88,122 | 364% |
| Allied Benefit Systems | $1,641 - $88,122 | 364% |
| Coventry | $1,641 - $88,122 | 364% |
| Trustmark | $1,641 - $88,122 | 364% |
| Allied Benefits Systems | $1,641 - $88,122 | 364% |
| Continental Benefits | $1,641 - $88,122 | 364% |