CMS Price Transparency Data

Blood transfusion

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $428
Cash Discount Price: $566
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Ascension Providence Hospital, Southfield and Novi is $428. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $566. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.95x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$566

Average discount available for prompt cash payment at this facility.

Insurance Median

$428

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: $566 (126%)

Insurance Median: $428 (95%)

Cash: $566 (126% of Medicare)

Ins. Median: $428 (95% 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
Hap Alliance Health	$38	8%
Hap Hmo Pos	$38	8%
Hap Preferred	$45	10%
Medicaid / KanCare	$184 - $428	41%
Molina Health	$184 - $248	41%
Blue Caid Michigan	$248	55%
Harbor Health Mcd	$248	55%
Total Health Care	$248	55%
UnitedHealthcare	$248	55%
Amerihealth Vip Care Mcr	$368 - $424	82%
Aetna	$428 - $721	95%
Auto Insurance	$428	95%
Jvhl - Mcr Replacement	$428	95%
Mcr Replacement	$428	95%
Veterans Choice	$428	95%
Humana	$433	96%
Meridian Wellcare	$450	100%
Molina Advantage	$450	100%
Ambetter / Centene	$535	119%
Molina Marketplace	$535	119%
Smart Health	$591	131%
Bc Metro Detroit Epo	$5,105 - $19,949	1133%
Bc Metro Detroit Hmo	$5,105 - $19,949	1133%
Bcn Local Network Southeast	$5,105 - $19,949	1133%
Blue Care Network	$5,105 - $19,949	1133%
Blue Cross Blue Shield	$5,105 - $19,949	1133%

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 $566.
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 Ascension Providence Hospital, Southfield and Novi 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.