CMS Price Transparency Data

Blood transfusion

Facility: Mt Sinai Hospital Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $473
  • Cash Discount Price: $493
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mt Sinai Hospital Medical Center is $473. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $493. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.05x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$493

Average discount available for prompt cash payment at this facility.

Insurance Median
$473

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: $493 (109%)
Insurance Median: $473 (105%)
Cash: $493 (109% of Medicare)
Ins. Median: $473 (105% 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
Partners In Hlth - All Plans $100 - $463 22%
Blue Cross Blue Shield $112 - $736 25%
Compsych Ip/Op Only - All Plans $151 - $694 34%
Healthlink Hmo $163 - $752 36%
Hfn Platinum $163 - $752 36%
Healthlink Ppo - All Other Plans $176 - $810 39%
Multiplan Primary Ntwrk/Phcs - All Other Plans $176 - $810 39%
Hfn Epo $201 - $926 45%
Multiplan Complementary Ntwrk $201 - $926 45%
Hfn Ppo - All Other Plans $221 - $1,018 49%
UnitedHealthcare $255 - $473 57%
Ambetter / Centene $264 - $1,215 59%
Oscar - All Plans $276 - $1,273 61%
Cigna $310 - $1,431 69%
Tricare $459 102%
Va Healthnet - All Plans $459 102%
Advocate Physician Prtnrs Mcr $473 105%
Cenpatico Illinicare Dual $473 105%
Cenpatico Illinicare Mcr - All Other Plans $473 105%
Humana $473 - $3,634 105%
Lawndale Christian - All Plans $473 105%
Meridian/Harmony D-Snp - All Plans $473 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $473 105%
Harmony Behavioral Htlh - All Plans $487 108%
Zing Mcr Adv - All Plans $492 109%
Molina Mcr - All Other Plans $496 110%
Advocate Physician Prtnrs - All Other Plans $520 115%
Aetna $568 - $2,616 126%
Family Health Network Mcaid - All Plans $635 141%
Molina Mcaid $667 148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals