CMS Price Transparency Data

Blood transfusion

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $562
Cash Discount Price: $1,749
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at UMass Memorial Healthalliance Hospitals is $562. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,749. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.25x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$1,749

Average discount available for prompt cash payment at this facility.

Insurance Median

$562

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: $1,749 (388%)

Insurance Median: $562 (125%)

Cash: $1,749 (388% of Medicare)

Ins. Median: $562 (125% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Hsno/Free Care [10801]	$294	65%
Champva [11001]	$467	104%
Cigna	$529 - $1,657	117%
Correctional Care [11003]	$529 - $535	117%
Institution [10406]	$529 - $927	117%
Medicaid / KanCare	$529 - $909	117%
Medicare (plans)	$529 - $535	117%
Tufts Dual [10111]	$529 - $535	117%
Tufts Us Family [11203]	$535	119%
Blue Cross Blue Shield	$546 - $706	121%
Aetna	$555 - $1,144	123%
Commonwealth Care Mcr [10115]	$555 - $562	123%
Fallon Mcr Supp [20202]	$555 - $562	123%
Harvard Pilgrim Mcr [10106]	$555 - $562	123%
Mgb Mcr [10124]	$555 - $562	123%
Tufts Mcr [10112]	$555 - $562	123%
UnitedHealthcare	$555 - $1,749	123%
Senior Whole Health [10110]	$566 - $573	126%
Workers Compensation [20501]	$575	128%
Harvard Pilgrim [10701]	$796 - $957	177%
Tufts Connectorcare [10507]	$899 - $910	199%
Tufts [11201]	$905	201%
Hne [11108]	$976	217%
Fallon Connectorcare [10503]	$1,185	263%
Wellpoint [11112]	$1,288	286%
First Health Network [11120]	$1,312	291%
Multiplan [11109]	$1,312	291%
Connecticare [11105]	$1,749	388%
Fallon Carelon Hlth [28]	$1,749	388%
Fallon Mcaid Carelon Hlth [29]	$1,749	388%
Grants [20507]	$1,749	388%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,749.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 36430.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Healthalliance Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 36430.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.