CMS Price Transparency Data

Blood transfusion

Facility: St. Vincent's East

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $487
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at St. Vincent's East is $487. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.08x the Medicare baseline. Located in 50 Medical Park East Drive, Birmingham, AL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$487

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%)

Insurance Median: $487 (108%)

Ins. Median: $487 (108% 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
Ambetter / Centene	$41 - $555	9%
Aetna	$103 - $416	23%
UnitedHealthcare	$159 - $424	35%
Blue Cross Blue Shield	$387	86%
Cooper Green	$404	90%
Viva	$404 - $499	90%
Humana	$408 - $524	91%
Cigna	$416	92%
Prime Health Services	$424 - $706	94%
Construction Claims Management	$487 - $601	108%
Corvel	$487 - $601	108%
Alamed	$516 - $636	114%
Multiplan	$539 - $666	120%
Pnoa	$539 - $666	120%
Seven Corners	$545	121%

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 $X.
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. Vincent's East 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.