CMS Price Transparency Data

Blood transfusion

Facility: Saint Mary's Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $1,569
  • Cash Discount Price: $2,140
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Saint Mary's Hospital is $1,569. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,140. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.48x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$2,140

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,569

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: $2,140 (475%)
Insurance Median: $1,569 (348%)
Cash: $2,140 (475% of Medicare)
Ins. Median: $1,569 (348% 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 348% of the Medicare baseline (a markup of 248%). 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.

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
Connecticut Dept of Correction $488 108%
Aetna $518 - $1,916 115%
Blue Cross Blue Shield $518 - $1,569 115%
Medicare (plans) $518 - $539 115%
UnitedHealthcare $518 - $2,425 115%
Cca Senior Care Options $529 117%
Cigna $534 - $1,940 118%
Centivo $1,058 235%
Claimdoc $1,111 246%
Diversified Administrators $1,111 246%
Innovative Health Plan II $1,111 246%
Carelon Behavioral Health $1,212 269%
Health New England $1,286 285%
Allegiance $1,310 291%
Health Partners $1,310 291%
Magnacare $1,310 291%
Bcn Domestic $1,569 348%
Blue Benefit Administrators of Massachusetts $1,569 348%
Blue Care Network $1,569 348%
Blue Distinction Transplant $1,569 348%
Blue Shield - Ca $1,569 348%
Blue Shield - Id (Regence) $1,569 348%
Blue Shield - Ny Highmark Northeastern $1,569 348%
Blue Shield - Ny Highmark Western $1,569 348%
Blue Shield - PA (Highmark) $1,569 348%
Blue Shield - Wa (Regence) $1,569 348%
Health Choices $1,569 348%
Kaiser Domestic $1,569 348%
Pre-Employment $1,569 348%
Unicare $1,569 348%
Wc Domestic $1,569 348%
Wellpoint $1,569 348%
Geha $1,576 350%
Harvard Pilgrim Healthcare $1,576 350%
Allied National Global Care $1,867 414%
Asrm - Reliance Standard Life Insurance $1,867 414%
Christian Care Ministry $1,867 414%
Dean Health $1,867 414%
Fallon Health $1,867 414%
Family Life Insurance Company $1,867 414%
Ghc Scw $1,867 414%
International Benefit Administrators $1,867 414%
Lifetime Benefit Solutions $1,867 414%
Manhattan Life $1,867 414%
Medi Share $1,867 414%
Multiplan $1,867 414%
Mvp $1,867 414%
PHCS $1,867 414%
Pai $1,867 414%
Pan-American Life $1,867 414%
Paramount HMO $1,867 414%
Trinity Health Share $1,867 414%
1199 National Benefit Fund $1,916 425%
Allied Benefit Systems $1,916 425%
Gravie Admin Services $1,916 425%
Hap $1,916 425%
Luminare Health $1,916 425%
Meritain $1,916 425%
Nippon Life Ins $1,916 425%
Webtpa $1,916 425%
Prime Health Services $1,940 430%
Health Smart $2,061 457%
United Behavioral Health Eap $2,425 538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals