CMS Price Transparency Data

Blood transfusion

Facility: North Adams Regional Hospital Corporation

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $534
  • Cash Discount Price: $895
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at North Adams Regional Hospital Corporation is $534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $895. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.18x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$895

Average discount available for prompt cash payment at this facility.

Insurance Median
$534

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: $895 (199%)
Insurance Median: $534 (118%)
Cash: $895 (199% of Medicare)
Ins. Median: $534 (118% 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.

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
Mcd Masshealth $31 - $1,042 7%
Mcd New York $31 - $515 7%
Mcd Out Of State $31 - $1,042 7%
Mcdmanaged Cdphp $31 - $1,042 7%
Mcdmanaged Hne Mcdaco $31 - $1,042 7%
Medicaid / KanCare $31 - $1,042 7%
Comm Network Qhpsub $34 - $533 8%
Mcdmanaged Network $34 - $533 8%
Mcdmanaged Bmchnp $36 - $1,083 8%
Tricare $44 - $355 10%
Medicare (plans) $49 - $219 11%
Comm Hospice $50 - $217 11%
Mcr Miscellaneous $50 - $217 11%
Mcrmanaged Usa Family $50 - $217 11%
Mcrmanaged Va $50 - $217 11%
Oth United Vaccn $50 - $217 11%
Blue Cross Blue Shield $56 - $801 12%
Mcrmanaged Cca One Care $56 - $215 12%
Aetna $59 - $712 13%
Comm Fallon Qhp $66 - $534 15%
Comm Hne Hmo $75 - $650 17%
Comm Unicare $78 - $611 17%
Comm Hne $80 - $688 18%
Comm Hne Ppo $80 - $691 18%
Wc Workers Comp $572 127%
Comm Network Qhpnonsub $603 - $678 134%
Comm Nhp $610 135%
Comm Tufts $747 166%
UnitedHealthcare $811 180%
Cigna $848 - $877 188%
Comm Cdphp $848 188%
Comm Mvp $848 188%
Comm Oxford $848 188%
Comm First Health $877 - $895 195%
Comm Connecticare $895 199%
Comm Consolidated Health $895 199%
Comm Harvard $895 199%
Comm Other $895 199%
Comm Phcs $895 199%
Comm Self Pay $895 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals