CMS Price Transparency Data

Blood transfusion

Facility: Presence Mercy Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $494
  • Cash Discount Price: $470
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Presence Mercy Medical Center is $494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $470. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.
Cash / Self-Pay
$470

Average discount available for prompt cash payment at this facility.

Insurance Median
$494

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: $470 (104%)
Insurance Median: $494 (110%)
Cash: $470 (104% of Medicare)
Ins. Median: $494 (110% 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
Ravenswood Physicians Associates Ipa $49 - $470 11%
Resurrection Physicians Provider Group Ipa $49 - $470 11%
Cigna $365 - $921 81%
Blue Cross Blue Shield $447 - $659 99%
Advocate Helath Partners $470 - $518 104%
Aetna $470 - $921 104%
Celtic (Wellcare) $470 104%
Clear Spring Health Of Illinois $470 104%
Devoted Health $470 104%
Essential Health Partners $470 - $541 104%
Health Alliance Medical Plan $470 104%
Humana $470 - $518 104%
Longevity Health Plan Of Illinois $470 104%
Medicare (plans) $470 104%
Self-Pay $470 104%
Tricare $470 104%
United Behavioral Health $470 104%
UnitedHealthcare $470 - $921 104%
Molina $485 - $706 108%
Zing Health Provider Network $485 108%
Meridian $494 - $532 110%
Provider Partners Health Plan (Pphp) $494 110%
Harmony Health Plan $499 - $532 111%
Medicaid / KanCare $507 - $532 112%
Standard Eapg Logic - Contracts $507 112%
Access Community Health Network $565 125%
Clifton Health Systems $729 162%
Ambetter / Centene $762 169%
Corvel $921 204%
Coventry $921 204%
Hfn Inc (Healthcare Finest Network) $921 204%
Workers Comp $921 204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1325 N Highland Avenue, Aurora, IL 60506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals