CMS Price Transparency Data
Blood transfusion
Facility: Saint Joseph Regional Medical Center
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $723
- Cash Discount Price: $3,393
- vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Saint Joseph Regional Medical Center is $723. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,393. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.60x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$3,393
Average discount available for prompt cash payment at this facility.
Insurance Median
$723
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: $3,393 (753%)
Insurance Median: $723 (160%)
Cash: $3,393 (753% of Medicare)
Ins. Median: $723 (160% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $103 - $900 | 23% |
| Blue Cross Blue Shield | $103 - $2,274 | 23% |
| Medicaid / KanCare | $103 - $2,274 | 23% |
| UnitedHealthcare | $103 - $2,274 | 23% |
| Medicare (plans) | $185 - $476 | 41% |
| Meridian Complete | $185 - $467 | 41% |
| Pace-Trinity Health | $185 - $467 | 41% |
| County Coroner | $192 - $485 | 43% |
| Provider Partners Health Plan Of Indiana | $203 - $513 | 45% |
| Auxiant | $277 - $1,150 | 61% |
| Physicians Health Plan Northern Indiana Health Insurance | $277 - $1,410 | 61% |
| St Joseph County Hlth Dpt | $277 - $700 | 61% |
| Caresource | $287 - $723 | 64% |
| Siho Insurance Services | $296 - $747 | 66% |
| Key Benefit Administrator | $333 - $1,004 | 74% |
| Allied Benefit Systems | $351 - $900 | 78% |
| Hospice Of Marshall County | $360 | 80% |
| Hospice Of St Joseph County | $360 | 80% |
| Plain Church Group | $374 | 83% |
| Managed Health Services - Indiana | $383 - $2,274 | 85% |
| Mdwise | $383 - $2,274 | 85% |
| Custom Design Benefits | $398 - $1,004 | 88% |
| Blue Benefit Administrators Of Massachusetts | $676 - $1,648 | 150% |
| Blue Care Network | $676 - $1,648 | 150% |
| Blue Distinction Transplant | $676 - $1,648 | 150% |
| Blue Shield - Ca | $676 - $1,648 | 150% |
| Blue Shield - Id (Regence) | $676 - $1,648 | 150% |
| Blue Shield - Ny Highmark Northeastern | $676 - $1,648 | 150% |
| Blue Shield - Ny Highmark Western | $676 - $1,648 | 150% |
| Blue Shield - Pa (Highmark) | $676 - $1,648 | 150% |
| Blue Shield - Wa (Regence) | $676 - $1,648 | 150% |
| Notre Dame Athletic Association | $762 | 169% |
| Wc Notre Dame | $762 | 169% |
| Luminare Health (Detroit) | $789 - $831 | 175% |
| Encore Health | $821 - $862 | 182% |
| Ameriben | $831 | 184% |
| Indiana Criminal Justice Inst | $862 | 191% |
| Western & Southern Financial Group | $862 | 191% |
| Geha | $882 | 196% |
| Healthscope | $882 | 196% |
| Student Insurance Cma | $882 | 196% |
| Cigna | $886 | 197% |
| Group Administrators | $886 | 197% |
| Health Partners | $886 | 197% |
| Mvp | $886 | 197% |
| Prairie States | $886 | 197% |
| Priority Health | $886 | 197% |
| Professional Benefit Administrators | $886 | 197% |
| Sagamore Health Network | $886 - $1,025 | 197% |
| Sisco Benefits | $886 | 197% |
| Unified Group Services | $886 | 197% |
| Asr Health Benefits | $900 | 200% |
| Christian Brother Services | $900 | 200% |
| Employee Benefit Management | $900 | 200% |
| Medical Mutual | $900 | 200% |
| Meritain | $900 | 200% |
| Preferred One | $900 | 200% |
| Rural Carrier Health Benefit Plan | $900 | 200% |
| Webtpa | $900 | 200% |
| Goshen Preferred Network | $1,066 - $1,191 | 237% |
| Christian Brothers Holy Cross | $1,108 | 246% |
| Signature Care | $1,108 | 246% |
| Bankers Life Casualty | $1,385 | 307% |
| Bureau Of Disability | $1,385 | 307% |
| Wc Align Network | $1,385 | 307% |