CMS Price Transparency Data
Blood transfusion
Facility: Mercy Health Saint Mary's
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $523
- Cash Discount Price: $1,350
- vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Health Saint Mary's is $523. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,350. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.16x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$1,350
Average discount available for prompt cash payment at this facility.
Insurance Median
$523
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: $1,350 (300%)
Insurance Median: $523 (116%)
Cash: $1,350 (300% of Medicare)
Ins. Median: $523 (116% 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 |
|---|---|---|
| U Of M Health Plan | $89 - $610 | 20% |
| Bcn Domestic | $162 | 36% |
| Blue Benefit Administrators Of Massachusetts | $162 | 36% |
| Blue Care Network | $162 | 36% |
| Blue Cross Blue Shield | $162 - $431 | 36% |
| Blue Distinction Transplant | $162 | 36% |
| Blue Shield - Ca | $162 | 36% |
| Blue Shield - Id (Regence) | $162 | 36% |
| Blue Shield - Ny Highmark Northeastern | $162 | 36% |
| Blue Shield - Ny Highmark Western | $162 | 36% |
| Blue Shield - Pa (Highmark) | $162 | 36% |
| Blue Shield - Wa (Regence) | $162 | 36% |
| Health Choices | $162 - $610 | 36% |
| Kaiser Domestic | $162 | 36% |
| Medicaid / KanCare | $246 - $251 | 55% |
| Access Health | $308 | 68% |
| Aetna | $354 - $503 | 79% |
| Blue Care Network Advantage | $431 | 96% |
| Medicare (plans) | $431 | 96% |
| Wc Accident Fund | $437 | 97% |
| Wc Advantage | $437 | 97% |
| Wc Aig | $437 | 97% |
| Wc Allied | $437 | 97% |
| Wc Amerisure | $437 | 97% |
| Wc Amtrust | $437 | 97% |
| Wc Asu Risk Mgt | $437 | 97% |
| Wc Berkley Admin | $437 | 97% |
| Wc Broadspire | $437 | 97% |
| Wc Bunch & Associates | $437 | 97% |
| Wc Ccmsi | $437 | 97% |
| Wc Emc Insurance Company | $437 | 97% |
| Wc Esis | $437 | 97% |
| Wc Fcci | $437 | 97% |
| Wc Federated | $437 | 97% |
| Wc Gallagher Bassett | $437 | 97% |
| Wc Genex Care For Ohio | $437 | 97% |
| Wc Guard Insurance Company | $437 | 97% |
| Wc Hartford | $437 | 97% |
| Wc Liberty Mutual | $437 | 97% |
| Wc Meijers | $437 | 97% |
| Wc Michigan | $437 | 97% |
| Wc Mitchell Frankenmuth | $437 | 97% |
| Wc Pma | $437 | 97% |
| Wc Sedgwick | $437 | 97% |
| Wc Sentry | $437 | 97% |
| Wc Travelers | $437 | 97% |
| Wc Tristar | $437 | 97% |
| Wc Walmart | $437 | 97% |
| Wc Zurich | $437 | 97% |
| Align Senior Care | $440 | 98% |
| Correctional Recovery | $440 | 98% |
| Hospice Faith | $440 | 98% |
| Hospice Of Holland | $440 | 98% |
| Nomi Health | $449 | 100% |
| UnitedHealthcare | $453 - $801 | 101% |
| Acs Benefit Services | $461 | 102% |
| Allied Benefit Systems | $461 | 102% |
| Claimchoice Adminstrators | $461 | 102% |
| Consociate | $461 | 102% |
| Cypress Benefit Administrators | $461 | 102% |
| Forest County Potawatomi | $461 | 102% |
| Health Smart | $461 | 102% |
| Healthgram | $461 | 102% |
| Healthscope | $461 | 102% |
| Secureone Preferred United Plans | $461 | 102% |
| Sisco Benefits | $461 | 102% |
| The Health Plan | $461 | 102% |
| Trustmark Small Business Benefits | $461 | 102% |
| Unified Group Services | $461 | 102% |
| Webtpa | $461 | 102% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $495 | 110% |
| Geha | $503 - $609 | 112% |
| Medical Mutual | $503 | 112% |
| Meritain | $503 | 112% |
| Preferred One | $503 | 112% |
| Asr Health Benefits | $510 | 113% |
| Hap | $510 - $621 | 113% |
| Varipro | $520 | 115% |
| Caresource | $523 | 116% |
| Oscar | $563 | 125% |
| Molina Marketplace | $571 | 127% |
| Cigna | $584 | 130% |
| 1199 National Benefit Fund | $585 | 130% |
| Allied National Global Care | $585 | 130% |
| Asrm - Reliance Standard Life Insurance | $585 | 130% |
| Christian Care Ministry | $585 | 130% |
| Dean Health | $585 | 130% |
| Fallon Health | $585 | 130% |
| Family Life Insurance Company | $585 | 130% |
| Ghc Scw | $585 | 130% |
| Group Pension Administrators | $585 | 130% |
| International Benefit Administrators | $585 | 130% |
| Lifetime Benefit Solutions | $585 | 130% |
| Manhattan Life | $585 | 130% |
| Medi Share | $585 | 130% |
| Multiplan | $585 | 130% |
| Mvp | $585 | 130% |
| Pai | $585 | 130% |
| Pan-American Life | $585 | 130% |
| Paramount Hmo | $585 | 130% |
| Phcs | $585 | 130% |
| Trinity Health Share | $585 | 130% |
| Acclaim | $610 | 135% |
| Administrative Concepts | $610 | 135% |
| Allegeant | $610 | 135% |
| Ameriben | $610 | 135% |
| American Family | $610 | 135% |
| American Healthcare Alliance | $610 | 135% |
| American Republic | $610 | 135% |
| Amerihealth | $610 | 135% |
| Aultcare | $610 | 135% |
| Automated Benefit Services | $610 | 135% |
| Auxiant | $610 | 135% |
| Benefit Administrative Systems,Llc | $610 | 135% |
| Boon Chapman | $610 | 135% |
| Cam Administrative Services | $610 | 135% |
| Christian Brother Services | $610 | 135% |
| Christian Brothers Holy Cross | $610 | 135% |
| Comprehensive Benefits | $610 | 135% |
| Continental Life Insurance | $610 | 135% |
| Custom Benefit Administrators | $610 | 135% |
| Employee Benefit Concepts | $610 | 135% |
| Employee Benefit Management | $610 | 135% |
| Enterprise Group Planning | $610 | 135% |
| Freedom Life Insurance Company | $610 | 135% |
| Group Administrators | $610 | 135% |
| Group Marketing Services | $610 | 135% |
| Guardian | $610 | 135% |
| Health America | $610 | 135% |
| Healthez | $610 | 135% |
| Humana | $610 - $801 | 135% |
| Insight | $610 | 135% |
| Intercare | $610 | 135% |
| Jfp Benefit Management | $610 | 135% |
| Jp Farley Corporation | $610 | 135% |
| Key Benefit Administrator | $610 | 135% |
| Liberty Union Life Assurance Co | $610 | 135% |
| Lucent Health | $610 | 135% |
| Luminare Health | $610 | 135% |
| Luminare Health (Detroit) | $610 | 135% |
| Medben | $610 | 135% |
| Medcost | $610 | 135% |
| Mutual Health Services | $610 | 135% |
| Mutual Of Omaha | $610 | 135% |
| Ncas | $610 | 135% |
| Nippon Life Ins | $610 | 135% |
| Nova | $610 | 135% |
| Painters Union Insurance Fund | $610 | 135% |
| Physicians Mutual | $610 | 135% |
| Plumbers Local 98 Insurance Fund | $610 | 135% |
| Prairie States | $610 | 135% |
| Primary Physician Care | $610 | 135% |
| Professional Benefit Administrators | $610 | 135% |
| The Loomis Company | $610 | 135% |
| Unicare | $610 | 135% |
| Us Health And Life | $610 | 135% |
| Valenz | $610 | 135% |
| Western & Southern Financial Group | $610 | 135% |
| Wps | $610 | 135% |
| Coventry | $634 | 141% |
| First Health | $634 | 141% |
| Vitalcore | $681 | 151% |
| Wellpath | $681 | 151% |
| Cmh Allegan County | $801 | 178% |
| Cmh Ausable Valley | $801 | 178% |
| Cmh Barry County | $801 | 178% |
| Cmh Berrien County | $801 | 178% |
| Cmh Cass County | $801 | 178% |
| Cmh Clinton-Eaton-Ingham County | $801 | 178% |
| Cmh Kalamazoo | $801 | 178% |
| Cmh Kent County | $801 | 178% |
| Cmh Lenawee County | $801 | 178% |
| Cmh Misc | $801 | 178% |
| Cmh Monroe County | $801 | 178% |
| Cmh Montcalm County | $801 | 178% |
| Cmh Muskegon County | $801 | 178% |
| Cmh Newaygo County | $801 | 178% |
| Cmh North Country | $801 | 178% |
| Cmh Northern Lakes County | $801 | 178% |
| Cmh Ottawa County | $801 | 178% |
| Cmh Van Buren County | $801 | 178% |
| Cmh West Mi County | $801 | 178% |
| Magellan Behavioral Health | $801 | 178% |
| Priority Health | $835 - $852 | 185% |