CMS Price Transparency Data

Blood transfusion

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $562
Cash Discount Price: $740
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at UMass Memorial Health - Harrington Hospital is $562. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $740. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.25x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$740

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: $740 (164%)

Insurance Median: $562 (125%)

Cash: $740 (164% 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
Workers Compensation [20501]	$361	80%
Medicaid / KanCare	$385	85%
Hne [11108]	$482	107%
Champva [11001]	$519	115%
Cigna	$526 - $576	117%
Tufts [11201]	$526	117%
Institution [10406]	$529 - $535	117%
Mgb Mcr [10124]	$529 - $535	117%
Tufts Us Family [11203]	$535	119%
Wellpoint [11112]	$545	121%
Blue Cross Blue Shield	$546 - $691	121%
Aetna	$555 - $740	123%
Commonwealth Care Alliance [10103]	$555 - $562	123%
Fallon Mcr Supp [20202]	$555 - $562	123%
Fallon Mcr [10105]	$555 - $562	123%
First Health Network [11120]	$555	123%
Tufts Mcr [10112]	$555 - $562	123%
UnitedHealthcare	$555 - $740	123%
Senior Whole Health [10110]	$566 - $573	126%
Evernorth Behavioral Health [27]	$592	131%
Hsno/Free Care [10801]	$681	151%
Connecticare [11105]	$740	164%
Fallon Carelon Hlth [28]	$740	164%
Fallon Mcaid Carelon Hlth [29]	$740	164%
Grants [20507]	$740	164%
Masshealth Mcd Mbhp [38]	$740	164%
Wellsense Mcaid Carelon Hlth [21]	$740	164%
Tufts Connectorcare [10507]	$899 - $910	199%
Harvard Pilgrim [10701]	$953 - $1,145	211%
Fallon Connectorcare [10503]	$1,185	263%

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 $740.
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 Health - Harrington Hospital 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.