CMS Price Transparency Data

Blood transfusion

Facility: Massachusetts General Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $582
Cash Discount Price: $1,292
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Massachusetts General Hospital is $582. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,292. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.29x the Medicare baseline. Located in 55 Fruit Street, Boston, MA.

Cash / Self-Pay

$1,292

Average discount available for prompt cash payment at this facility.

Insurance Median

$582

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: $1,292 (287%)

Insurance Median: $582 (129%)

Cash: $1,292 (287% of Medicare)

Ins. Median: $582 (129% 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
Blue Cross Blue Shield	$438 - $519	97%
Tufts Health Plan [170001]	$509	113%
Tufts Health Public Plans [1013]	$509	113%
UnitedHealthcare	$509 - $1,407	113%
Commonwealth Care Alliance [1007]	$519	115%
Elder Services [1037]	$519	115%
Humana	$519	115%
Martin'S Point [160007]	$519	115%
Medicare (plans)	$519	115%
Mgb Health Plan [150001]	$519 - $660	115%
Aetna	$535 - $1,202	119%
Centers Of Excellence [1026]	$649 - $1,236	144%
Cigna	$918 - $1,369	204%
International Commercial [140001]	$1,119	248%
Wellpoint [1015]	$1,270	282%

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 $1,292.
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 Massachusetts General 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.