CMS Price Transparency Data
Blood transfusion
Facility: Saint Joseph Regional Medical Center - Plymouth
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $900
- Cash Discount Price: $2,305
- vs. Medicare Baseline: 2.00x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Saint Joseph Regional Medical Center - Plymouth is $900. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,305. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.00x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$2,305
Average discount available for prompt cash payment at this facility.
Insurance Median
$900
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: $2,305 (511%)
Insurance Median: $900 (200%)
Cash: $2,305 (511% of Medicare)
Ins. Median: $900 (200% 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 | $242 - $900 | 54% |
| Blue Cross Blue Shield | $242 - $1,648 | 54% |
| Medicaid / KanCare | $242 - $383 | 54% |
| UnitedHealthcare | $242 - $882 | 54% |
| Plain Church Group | $374 | 83% |
| Managed Health Services - Indiana | $383 | 85% |
| Mdwise | $383 | 85% |
| Medicare (plans) | $467 - $476 | 104% |
| Meridian Complete | $467 | 104% |
| Pace-Trinity Health | $467 | 104% |
| County Coroner | $485 | 108% |
| Provider Partners Health Plan Of Indiana | $513 | 114% |
| Auxiant | $700 - $1,150 | 155% |
| Physicians Health Plan Northern Indiana Health Insurance | $700 - $1,410 | 155% |
| St Joseph County Hlth Dpt | $700 | 155% |
| Caresource | $723 | 160% |
| Siho Insurance Services | $747 | 166% |
| Notre Dame Athletic Association | $762 | 169% |
| Wc Notre Dame | $762 | 169% |
| Luminare Health (Detroit) | $789 - $831 | 175% |
| Ameriben | $831 | 184% |
| Key Benefit Administrator | $840 - $1,004 | 186% |
| Geha | $882 | 196% |
| Healthscope | $882 | 196% |
| Student Insurance Cma | $882 | 196% |
| Allied Benefit Systems | $887 - $900 | 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% |
| Encore Health | $971 | 215% |
| Indiana Criminal Justice Inst | $971 | 215% |
| Western & Southern Financial Group | $971 | 215% |
| Cigna | $997 | 221% |
| Group Administrators | $997 | 221% |
| Health Partners | $997 | 221% |
| Mvp | $997 | 221% |
| Prairie States | $997 | 221% |
| Priority Health | $997 | 221% |
| Professional Benefit Administrators | $997 | 221% |
| Sagamore Health Network | $997 - $1,066 | 221% |
| Sisco Benefits | $997 | 221% |
| Unified Group Services | $997 | 221% |
| Custom Design Benefits | $1,004 | 223% |
| Goshen Preferred Network | $1,066 - $1,191 | 237% |
| Signature Care | $1,150 | 255% |
| Allied National Global Care | $1,246 | 276% |
| Asrm - Reliance Standard Life Insurance | $1,246 | 276% |
| Avmed Health Plan | $1,246 | 276% |
| Christian Care Ministry | $1,246 | 276% |
| Dean Health | $1,246 | 276% |
| Fallon Health | $1,246 | 276% |
| Family Life Insurance Company | $1,246 | 276% |
| Freedom Life Insurance Company | $1,246 | 276% |
| Ghc Scw | $1,246 | 276% |
| International Benefit Administrators | $1,246 | 276% |
| Lifetime Benefit Solutions | $1,246 | 276% |
| Manhattan Life | $1,246 | 276% |
| Medi Share | $1,246 | 276% |
| Multiplan | $1,246 | 276% |
| Pai | $1,246 | 276% |
| Pan-American Life | $1,246 | 276% |
| Paramount Hmo | $1,246 | 276% |
| Phcs | $1,246 | 276% |
| Philadelphia American Life Insurance | $1,246 | 276% |
| Trinity Health Share | $1,246 | 276% |
| Bankers Life Casualty | $1,385 | 307% |
| Bureau Of Disability | $1,385 | 307% |
| Wc Align Network | $1,385 | 307% |
| Blue Benefit Administrators Of Massachusetts | $1,648 | 366% |
| Blue Care Network | $1,648 | 366% |
| Blue Distinction Transplant | $1,648 | 366% |
| Blue Shield - Ca | $1,648 | 366% |
| Blue Shield - Id (Regence) | $1,648 | 366% |
| Blue Shield - Ny Highmark Northeastern | $1,648 | 366% |
| Blue Shield - Ny Highmark Western | $1,648 | 366% |
| Blue Shield - Pa (Highmark) | $1,648 | 366% |
| Blue Shield - Wa (Regence) | $1,648 | 366% |