CMS Price Transparency Data
Blood transfusion
Facility: Trinity Health Oakland Hospital
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $630
- Cash Discount Price: $4,001
- vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Trinity Health Oakland Hospital is $630. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,001. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.40x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$4,001
Average discount available for prompt cash payment at this facility.
Insurance Median
$630
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: $4,001 (888%)
Insurance Median: $630 (140%)
Cash: $4,001 (888% of Medicare)
Ins. Median: $630 (140% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Asr Health Benefits | $83 | 18% |
| Caresource | $83 | 18% |
| Hap | $83 - $1,042 | 18% |
| Varipro | $83 | 18% |
| U Of M Health Plan | $89 | 20% |
| Blue Cross Blue Shield | $94 - $431 | 21% |
| Bcn Domestic | $152 | 34% |
| Blue Benefit Administrators Of Massachusetts | $152 | 34% |
| Blue Care Network | $152 | 34% |
| Blue Distinction Transplant | $152 | 34% |
| Blue Shield - Ca | $152 | 34% |
| Blue Shield - Id (Regence) | $152 | 34% |
| Blue Shield - Ny Highmark Northeastern | $152 | 34% |
| Blue Shield - Ny Highmark Western | $152 | 34% |
| Blue Shield - Pa (Highmark) | $152 | 34% |
| Blue Shield - Wa (Regence) | $152 | 34% |
| Health Choices | $152 - $1,050 | 34% |
| Kaiser Domestic | $152 | 34% |
| Medicaid / KanCare | $242 - $246 | 54% |
| Priority Health | $372 - $414 | 83% |
| Aetna | $431 - $896 | 96% |
| Blue Care Network Advantage | $431 | 96% |
| Medicare (plans) | $431 - $440 | 96% |
| Wc Accident Fund | $434 | 96% |
| Wc Advantage | $434 | 96% |
| Wc Aig | $434 | 96% |
| Wc Allied | $434 | 96% |
| Wc Amerisure | $434 | 96% |
| Wc Amtrust | $434 | 96% |
| Wc Asu Risk Mgt | $434 | 96% |
| Wc Berkley Admin | $434 | 96% |
| Wc Broadspire | $434 | 96% |
| Wc Bunch & Associates | $434 | 96% |
| Wc Ccmsi | $434 | 96% |
| Wc Emc Insurance Company | $434 | 96% |
| Wc Esis | $434 | 96% |
| Wc Fcci | $434 | 96% |
| Wc Federated | $434 | 96% |
| Wc Gallagher Bassett | $434 | 96% |
| Wc Genex Care For Ohio | $434 | 96% |
| Wc Guard Insurance Company | $434 | 96% |
| Wc Hartford | $434 | 96% |
| Wc Liberty Mutual | $434 | 96% |
| Wc Meijers | $434 | 96% |
| Wc Michigan | $434 | 96% |
| Wc Mitchell Frankenmuth | $434 | 96% |
| Wc Pma | $434 | 96% |
| Wc Sedgwick | $434 | 96% |
| Wc Sentry | $434 | 96% |
| Wc Travelers | $434 | 96% |
| Wc Tristar | $434 | 96% |
| Wc Walmart | $434 | 96% |
| Wc Zurich | $434 | 96% |
| Align Senior Care | $440 | 98% |
| Hospice Advantage | $440 | 98% |
| UnitedHealthcare | $453 - $1,073 | 101% |
| Cca - Zing Health | $465 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $495 | 110% |
| Molina Marketplace | $571 | 127% |
| Acs Benefit Services | $630 | 140% |
| Allied Benefit Systems | $630 | 140% |
| Claimchoice Adminstrators | $630 | 140% |
| Consociate | $630 | 140% |
| Cypress Benefit Administrators | $630 | 140% |
| Forest County Potawatomi | $630 | 140% |
| Health Smart | $630 | 140% |
| Healthgram | $630 | 140% |
| Healthscope | $630 | 140% |
| Secureone Preferred United Plans | $630 | 140% |
| Sisco Benefits | $630 | 140% |
| The Health Plan | $630 | 140% |
| Trustmark Small Business Benefits | $630 | 140% |
| Unified Group Services | $630 | 140% |
| Webtpa | $630 | 140% |
| Health Cost Solutions | $681 | 151% |
| Vitalcore | $681 | 151% |
| Wellpath | $681 | 151% |
| Mclaren Health | $688 - $750 | 153% |
| Carelon Behavioral Health | $716 | 159% |
| Magellan Behavioral Health | $859 | 191% |
| Geha | $896 - $1,073 | 199% |
| Medical Mutual | $896 | 199% |
| Meritain | $896 | 199% |
| 1199 National Benefit Fund | $973 | 216% |
| Allied National Global Care | $973 | 216% |
| Asrm - Reliance Standard Life Insurance | $973 | 216% |
| Christian Care Ministry | $973 | 216% |
| Dean Health | $973 | 216% |
| Fallon Health | $973 | 216% |
| Family Life Insurance Company | $973 | 216% |
| Ghc Scw | $973 | 216% |
| Group Pension Administrators | $973 | 216% |
| International Benefit Administrators | $973 | 216% |
| Lifetime Benefit Solutions | $973 | 216% |
| Manhattan Life | $973 | 216% |
| Medi Share | $973 | 216% |
| Multiplan | $973 | 216% |
| Mvp | $973 | 216% |
| Pai | $973 | 216% |
| Pan-American Life | $973 | 216% |
| Paramount Hmo | $973 | 216% |
| Phcs | $973 | 216% |
| Trinity Health Share | $973 | 216% |
| Employee Benefit Logistic | $1,014 | 225% |
| Health Partners | $1,042 | 231% |
| Tufts Health Plan | $1,042 | 231% |
| Access Health | $1,050 | 233% |
| Acclaim | $1,050 | 233% |
| Administrative Concepts | $1,050 | 233% |
| Allegeant | $1,050 | 233% |
| Ameriben | $1,050 | 233% |
| American Family | $1,050 | 233% |
| American Healthcare Alliance | $1,050 | 233% |
| American National | $1,050 | 233% |
| American Republic | $1,050 | 233% |
| Amerihealth | $1,050 | 233% |
| Aultcare | $1,050 | 233% |
| Automated Benefit Services | $1,050 | 233% |
| Auxiant | $1,050 | 233% |
| Benefit Administrative Systems,Llc | $1,050 | 233% |
| Boon Chapman | $1,050 | 233% |
| Cam Administrative Services | $1,050 | 233% |
| Christian Brother Services | $1,050 | 233% |
| Christian Brothers Holy Cross | $1,050 | 233% |
| Comprehensive Benefits | $1,050 | 233% |
| Continental Life Insurance | $1,050 | 233% |
| Custom Benefit Administrators | $1,050 | 233% |
| Employee Benefit Concepts | $1,050 | 233% |
| Employee Benefit Management | $1,050 | 233% |
| Enterprise Group Planning | $1,050 | 233% |
| Freedom Life Insurance Company | $1,050 | 233% |
| Group Administrators | $1,050 | 233% |
| Group Marketing Services | $1,050 | 233% |
| Guardian | $1,050 | 233% |
| Health America | $1,050 | 233% |
| Healthcare Management Admin | $1,050 | 233% |
| Healthez | $1,050 | 233% |
| Humana | $1,050 | 233% |
| Insight | $1,050 | 233% |
| Intercare | $1,050 | 233% |
| Jfp Benefit Management | $1,050 | 233% |
| Jp Farley Corporation | $1,050 | 233% |
| Key Benefit Administrator | $1,050 | 233% |
| Liberty Union Life Assurance Co | $1,050 | 233% |
| Lucent Health | $1,050 | 233% |
| Luminare Health | $1,050 | 233% |
| Luminare Health (Detroit) | $1,050 | 233% |
| Magnacare | $1,050 | 233% |
| Medben | $1,050 | 233% |
| Medcost | $1,050 | 233% |
| Mutual Health Services | $1,050 | 233% |
| Mutual Of Omaha | $1,050 | 233% |
| Ncas | $1,050 | 233% |
| Nippon Life Ins | $1,050 | 233% |
| Nova | $1,050 | 233% |
| Painters Union Insurance Fund | $1,050 | 233% |
| Physicians Mutual | $1,050 | 233% |
| Plumbers Local 98 Insurance Fund | $1,050 | 233% |
| Prairie States | $1,050 | 233% |
| Preferred One | $1,050 | 233% |
| Primary Physician Care | $1,050 | 233% |
| Professional Benefit Administrators | $1,050 | 233% |
| Siho Insurance Services | $1,050 | 233% |
| The Loomis Company | $1,050 | 233% |
| Unicare | $1,050 | 233% |
| Us Health And Life | $1,050 | 233% |
| Valenz | $1,050 | 233% |
| Western & Southern Financial Group | $1,050 | 233% |
| Wps | $1,050 | 233% |
| Cigna | $1,061 | 235% |
| Coventry | $1,079 | 239% |
| First Health | $1,079 | 239% |
| Prime Health Services | $1,145 | 254% |
| Three Rivers Provider Network | $1,288 | 286% |
| Cmh Detroit Wayne Integrated Health Network | $1,431 | 317% |
| Cmh Lenawee County | $1,431 | 317% |
| Cmh Livingston County | $1,431 | 317% |
| Cmh Misc | $1,431 | 317% |
| Cmh Monroe County | $1,431 | 317% |
| Cmh Oakland County | $1,431 | 317% |
| Cmh Washtenaw County | $1,431 | 317% |