CMS Price Transparency Data
Blood transfusion
Facility: Trinity Health Muskegon Hospital
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $500
- Cash Discount Price: $1,058
- vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Trinity Health Muskegon Hospital is $500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,058. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.11x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$1,058
Average discount available for prompt cash payment at this facility.
Insurance Median
$500
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: $1,058 (235%)
Insurance Median: $500 (111%)
Cash: $1,058 (235% of Medicare)
Ins. Median: $500 (111% 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.
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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 - $631 | 20% |
| Blue Cross Blue Shield | $246 - $461 | 55% |
| Medicaid / KanCare | $246 - $251 | 55% |
| Access Health | $330 | 73% |
| Aetna | $337 - $543 | 75% |
| Bcn Domestic | $359 | 80% |
| Blue Benefit Administrators Of Massachusetts | $359 | 80% |
| Blue Care Network | $359 | 80% |
| Blue Distinction Transplant | $359 | 80% |
| Blue Shield - Ca | $359 | 80% |
| Blue Shield - Id (Regence) | $359 | 80% |
| Blue Shield - Ny Highmark Northeastern | $359 | 80% |
| Blue Shield - Ny Highmark Western | $359 | 80% |
| Blue Shield - Pa (Highmark) | $359 | 80% |
| Blue Shield - Wa (Regence) | $359 | 80% |
| Health Choices | $359 - $631 | 80% |
| Kaiser Domestic | $359 | 80% |
| Acs Benefit Services | $417 | 93% |
| Allied Benefit Systems | $417 | 93% |
| Claimchoice Adminstrators | $417 | 93% |
| Consociate | $417 | 93% |
| Cypress Benefit Administrators | $417 | 93% |
| Forest County Potawatomi | $417 | 93% |
| Health Smart | $417 | 93% |
| Healthgram | $417 | 93% |
| Healthscope | $417 | 93% |
| Preferred One | $417 | 93% |
| Secureone Preferred United Plans | $417 | 93% |
| Sisco Benefits | $417 | 93% |
| The Health Plan | $417 | 93% |
| Trustmark Small Business Benefits | $417 | 93% |
| Unified Group Services | $417 | 93% |
| Webtpa | $417 | 93% |
| Asr Health Benefits | $425 | 94% |
| Hap | $425 - $635 | 94% |
| Wc Accident Fund | $427 | 95% |
| Wc Advantage | $427 | 95% |
| Wc Aig | $427 | 95% |
| Wc Allied | $427 | 95% |
| Wc Amerisure | $427 | 95% |
| Wc Amtrust | $427 | 95% |
| Wc Asu Risk Mgt | $427 | 95% |
| Wc Berkley Admin | $427 | 95% |
| Wc Broadspire | $427 | 95% |
| Wc Bunch & Associates | $427 | 95% |
| Wc Ccmsi | $427 | 95% |
| Wc Emc Insurance Company | $427 | 95% |
| Wc Esis | $427 | 95% |
| Wc Fcci | $427 | 95% |
| Wc Federated | $427 | 95% |
| Wc Gallagher Bassett | $427 | 95% |
| Wc Genex Care For Ohio | $427 | 95% |
| Wc Guard Insurance Company | $427 | 95% |
| Wc Hartford | $427 | 95% |
| Wc Liberty Mutual | $427 | 95% |
| Wc Meijers | $427 | 95% |
| Wc Michigan | $427 | 95% |
| Wc Mitchell Frankenmuth | $427 | 95% |
| Wc Pma | $427 | 95% |
| Wc Sedgwick | $427 | 95% |
| Wc Sentry | $427 | 95% |
| Wc Travelers | $427 | 95% |
| Wc Tristar | $427 | 95% |
| Wc Walmart | $427 | 95% |
| Wc Zurich | $427 | 95% |
| Hospice Of Michigan | $441 | 98% |
| Priority Health | $447 - $500 | 99% |
| Nomi Health | $449 | 100% |
| Blue Care Network Advantage | $461 | 102% |
| Medicare (plans) | $461 | 102% |
| Varipro | $464 | 103% |
| Align Senior Care | $471 | 104% |
| Correctional Recovery | $471 | 104% |
| Heartland Hospice | $471 | 104% |
| Hospice Harbor Hospice | $471 | 104% |
| UnitedHealthcare | $485 - $705 | 108% |
| Caresource | $504 | 112% |
| Cigna | $504 | 112% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $531 | 118% |
| Geha | $543 - $705 | 120% |
| Meritain | $543 | 120% |
| 1199 National Benefit Fund | $601 | 133% |
| Allied National Global Care | $601 | 133% |
| Asrm - Reliance Standard Life Insurance | $601 | 133% |
| Christian Care Ministry | $601 | 133% |
| Dean Health | $601 | 133% |
| Fallon Health | $601 | 133% |
| Family Life Insurance Company | $601 | 133% |
| Ghc Scw | $601 | 133% |
| Group Pension Administrators | $601 | 133% |
| International Benefit Administrators | $601 | 133% |
| Lifetime Benefit Solutions | $601 | 133% |
| Manhattan Life | $601 | 133% |
| Medi Share | $601 | 133% |
| Multiplan | $601 | 133% |
| Mvp | $601 | 133% |
| Pai | $601 | 133% |
| Pan-American Life | $601 | 133% |
| Paramount Hmo | $601 | 133% |
| Phcs | $601 | 133% |
| Trinity Health Share | $601 | 133% |
| Oscar | $603 | 134% |
| Molina Marketplace | $612 | 136% |
| Acclaim | $631 | 140% |
| Administrative Concepts | $631 | 140% |
| Allegeant | $631 | 140% |
| Ameriben | $631 | 140% |
| American Family | $631 | 140% |
| American Healthcare Alliance | $631 | 140% |
| American Republic | $631 | 140% |
| Amerihealth | $631 | 140% |
| Aultcare | $631 | 140% |
| Automated Benefit Services | $631 | 140% |
| Auxiant | $631 | 140% |
| Benefit Administrative Systems,Llc | $631 | 140% |
| Boon Chapman | $631 | 140% |
| Cam Administrative Services | $631 | 140% |
| Christian Brother Services | $631 | 140% |
| Christian Brothers Holy Cross | $631 | 140% |
| Comprehensive Benefits | $631 | 140% |
| Continental Life Insurance | $631 | 140% |
| Custom Benefit Administrators | $631 | 140% |
| Employee Benefit Concepts | $631 | 140% |
| Employee Benefit Management | $631 | 140% |
| Enterprise Group Planning | $631 | 140% |
| Freedom Life Insurance Company | $631 | 140% |
| Group Administrators | $631 | 140% |
| Group Marketing Services | $631 | 140% |
| Guardian | $631 | 140% |
| Health America | $631 | 140% |
| Healthez | $631 | 140% |
| Humana | $631 | 140% |
| Insight | $631 | 140% |
| Intercare | $631 | 140% |
| Jfp Benefit Management | $631 | 140% |
| Jp Farley Corporation | $631 | 140% |
| Key Benefit Administrator | $631 | 140% |
| Liberty Union Life Assurance Co | $631 | 140% |
| Lucent Health | $631 | 140% |
| Luminare Health | $631 | 140% |
| Luminare Health (Detroit) | $631 | 140% |
| Medben | $631 | 140% |
| Medcost | $631 | 140% |
| Medical Mutual | $631 | 140% |
| Mutual Health Services | $631 | 140% |
| Mutual Of Omaha | $631 | 140% |
| Ncas | $631 | 140% |
| Nippon Life Ins | $631 | 140% |
| Nova | $631 | 140% |
| Painters Union Insurance Fund | $631 | 140% |
| Physicians Mutual | $631 | 140% |
| Plumbers Local 98 Insurance Fund | $631 | 140% |
| Prairie States | $631 | 140% |
| Primary Physician Care | $631 | 140% |
| Professional Benefit Administrators | $631 | 140% |
| The Loomis Company | $631 | 140% |
| Unicare | $631 | 140% |
| Us Health And Life | $631 | 140% |
| Valenz | $631 | 140% |
| Western & Southern Financial Group | $631 | 140% |
| Wps | $631 | 140% |
| First Health | $657 | 146% |
| Vitalcore | $730 | 162% |
| Wellpath | $730 | 162% |
| Barinet | $801 | 178% |
| Cmh Allegan County | $801 | 178% |
| Cmh Barry County | $801 | 178% |
| Cmh Berrien County | $801 | 178% |
| Cmh Cass County | $801 | 178% |
| Cmh Kalamazoo | $801 | 178% |
| Cmh Kent County | $801 | 178% |
| Cmh Misc | $801 | 178% |
| Cmh Muskegon 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% |