CMS Price Transparency Data

Blood transfusion

Facility: Karmanos Cancer Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $427
Cash Discount Price: $660
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Karmanos Cancer Center is $427. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $660. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.95x the Medicare baseline. Located in 4100 John R, Detroit, MI.

Cash / Self-Pay

$660

Average discount available for prompt cash payment at this facility.

Insurance Median

$427

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: $660 (146%)

Insurance Median: $427 (95%)

Cash: $660 (146% of Medicare)

Ins. Median: $427 (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
Detroit Medical Center	$33 - $3,825	7%
Interlink Bmt	$63 - $7,257	14%
Phcs-Multiplan	$68 - $7,775	15%
Blue Cross Blue Shield	$148	33%
Medicaid / KanCare	$239 - $268	53%
Priority Health	$383 - $1,148	85%
Tricare	$386	86%
Humana	$427	95%
Medicare (plans)	$427 - $435	95%
Mi Amish Medical Board	$427	95%
UnitedHealthcare	$453 - $907	101%
Aetna	$493 - $1,479	109%

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 $660.
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 Karmanos Cancer Center 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.