CMS Price Transparency Data

Blood transfusion

Facility: Holyoke Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $536
Cash Discount Price: $442
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Holyoke Medical Center is $536. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $442. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.19x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.

Cash / Self-Pay

$442

Average discount available for prompt cash payment at this facility.

Insurance Median

$536

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: $442 (98%)

Insurance Median: $536 (119%)

Cash: $442 (98% of Medicare)

Ins. Median: $536 (119% 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
Harvard Pilgrim	$383 - $582	85%
UnitedHealthcare	$383 - $1,085	85%
Aetna	$466	103%
Blue Cross Blue Shield	$466 - $617	103%
Health New England	$466 - $577	103%
Tufts Health Plan	$466 - $550	103%
Commonwealth Care Alliance	$490	109%
Wellsense Sco	$494	110%
Fallon	$499 - $577	111%
Wellcare	$499	111%
Senior Whole Health	$536	119%
Cigna	$550 - $838	122%
Tufts Health Public Plans	$559	124%
Bmchp	$577	128%
Wellsense Direct Metals Silver	$721	160%
Magellan	$1,103 - $1,500	245%

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 $442.
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 Holyoke Medical Center 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.