CMS Price Transparency Data

Blood transfusion

Facility: Methodist Hospitals Inc

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $866
  • Cash Discount Price: $1,093
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Methodist Hospitals Inc is $866. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,093. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 600 Grant St, Gary, IN.
Cash / Self-Pay
$1,093

Average discount available for prompt cash payment at this facility.

Insurance Median
$866

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: $1,093 (242%)
Insurance Median: $866 (192%)
Cash: $1,093 (242% of Medicare)
Ins. Median: $866 (192% 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
Blue Cross Blue Shield $85 - $1,343 19%
Caresource $383 85%
Humana $383 - $464 85%
Managed Health Services $383 85%
Medicaid / KanCare $383 85%
UnitedHealthcare $383 - $933 85%
Aetna $464 - $1,156 103%
Medicare (plans) $464 103%
United Heathcare $464 103%
Zing $474 105%
Cigna $600 - $651 133%
Caresource Maketplace $766 170%
Physicians Health Plan Of Northern Indiana $903 200%
Ambetter / Centene $929 206%
Encore $937 - $1,390 208%
Phcs $1,062 236%
Siho $1,093 242%
Sagamore $1,125 250%
Multiplan $1,140 253%
Hfn $1,218 - $1,328 270%
Magnacare $2,207 490%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Grant St, Gary, IN 46402
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals