CMS Price Transparency Data
Blood transfusion
Facility: Mercy Health Lakeshore Campus
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $689
- Cash Discount Price: $1,164
- vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mercy Health Lakeshore Campus is $689. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,164. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.53x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$1,164
Average discount available for prompt cash payment at this facility.
Insurance Median
$689
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: $1,164 (258%)
Insurance Median: $689 (153%)
Cash: $1,164 (258% of Medicare)
Ins. Median: $689 (153% 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 - $717 | 20% |
| Access Health | $140 | 31% |
| Blue Care Network Advantage | $196 | 43% |
| Blue Cross Blue Shield | $196 - $685 | 43% |
| Medicare (plans) | $196 | 43% |
| Aetna | $200 - $638 | 44% |
| Align Senior Care | $200 | 44% |
| Correctional Recovery | $200 | 44% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $226 | 50% |
| Oscar | $246 | 55% |
| Vitalcore | $267 | 59% |
| UnitedHealthcare | $281 - $721 | 62% |
| Medicaid / KanCare | $332 - $339 | 74% |
| Molina Marketplace | $333 | 74% |
| Hospice Of Michigan | $441 | 98% |
| Nomi Health | $449 | 100% |
| Hap | $600 - $735 | 133% |
| Wc Accident Fund | $632 | 140% |
| Wc Advantage | $632 | 140% |
| Wc Aig | $632 | 140% |
| Wc Allied | $632 | 140% |
| Wc Amerisure | $632 | 140% |
| Wc Amtrust | $632 | 140% |
| Wc Asu Risk Mgt | $632 | 140% |
| Wc Berkley Admin | $632 | 140% |
| Wc Broadspire | $632 | 140% |
| Wc Bunch & Associates | $632 | 140% |
| Wc Ccmsi | $632 | 140% |
| Wc Emc Insurance Company | $632 | 140% |
| Wc Esis | $632 | 140% |
| Wc Fcci | $632 | 140% |
| Wc Federated | $632 | 140% |
| Wc Gallagher Bassett | $632 | 140% |
| Wc Genex Care For Ohio | $632 | 140% |
| Wc Guard Insurance Company | $632 | 140% |
| Wc Hartford | $632 | 140% |
| Wc Liberty Mutual | $632 | 140% |
| Wc Meijers | $632 | 140% |
| Wc Michigan | $632 | 140% |
| Wc Mitchell Frankenmuth | $632 | 140% |
| Wc Pma | $632 | 140% |
| Wc Sedgwick | $632 | 140% |
| Wc Sentry | $632 | 140% |
| Wc Travelers | $632 | 140% |
| Wc Tristar | $632 | 140% |
| Wc Walmart | $632 | 140% |
| Wc Zurich | $632 | 140% |
| Geha | $638 - $721 | 142% |
| Meritain | $638 | 142% |
| Wellpath | $660 | 146% |
| Asr Health Benefits | $667 | 148% |
| Bcn Domestic | $685 | 152% |
| Blue Benefit Administrators Of Massachusetts | $685 | 152% |
| Blue Care Network | $685 | 152% |
| Blue Distinction Transplant | $685 | 152% |
| Blue Shield - Ca | $685 | 152% |
| Blue Shield - Id (Regence) | $685 | 152% |
| Blue Shield - Ny Highmark Northeastern | $685 | 152% |
| Blue Shield - Ny Highmark Western | $685 | 152% |
| Blue Shield - Pa (Highmark) | $685 | 152% |
| Blue Shield - Wa (Regence) | $685 | 152% |
| Health Choices | $685 - $717 | 152% |
| Kaiser Domestic | $685 | 152% |
| 1199 National Benefit Fund | $689 | 153% |
| Allied National Global Care | $689 | 153% |
| Asrm - Reliance Standard Life Insurance | $689 | 153% |
| Christian Care Ministry | $689 | 153% |
| Dean Health | $689 | 153% |
| Fallon Health | $689 | 153% |
| Family Life Insurance Company | $689 | 153% |
| Ghc Scw | $689 | 153% |
| Group Pension Administrators | $689 | 153% |
| International Benefit Administrators | $689 | 153% |
| Lifetime Benefit Solutions | $689 | 153% |
| Manhattan Life | $689 | 153% |
| Medi Share | $689 | 153% |
| Multiplan | $689 | 153% |
| Mvp | $689 | 153% |
| Pai | $689 | 153% |
| Pan-American Life | $689 | 153% |
| Paramount Hmo | $689 | 153% |
| Phcs | $689 | 153% |
| Trinity Health Share | $689 | 153% |
| Cigna | $695 | 154% |
| Caresource | $715 | 159% |
| Acclaim | $717 | 159% |
| Administrative Concepts | $717 | 159% |
| Allegeant | $717 | 159% |
| Allied Benefit Systems | $717 | 159% |
| Ameriben | $717 | 159% |
| American Family | $717 | 159% |
| American Healthcare Alliance | $717 | 159% |
| American Republic | $717 | 159% |
| Amerihealth | $717 | 159% |
| Aultcare | $717 | 159% |
| Automated Benefit Services | $717 | 159% |
| Auxiant | $717 | 159% |
| Benefit Administrative Systems,Llc | $717 | 159% |
| Boon Chapman | $717 | 159% |
| Cam Administrative Services | $717 | 159% |
| Christian Brother Services | $717 | 159% |
| Christian Brothers Holy Cross | $717 | 159% |
| Claimchoice Adminstrators | $717 | 159% |
| Comprehensive Benefits | $717 | 159% |
| Consociate | $717 | 159% |
| Continental Life Insurance | $717 | 159% |
| Custom Benefit Administrators | $717 | 159% |
| Cypress Benefit Administrators | $717 | 159% |
| Employee Benefit Concepts | $717 | 159% |
| Employee Benefit Management | $717 | 159% |
| Enterprise Group Planning | $717 | 159% |
| Forest County Potawatomi | $717 | 159% |
| Freedom Life Insurance Company | $717 | 159% |
| Group Administrators | $717 | 159% |
| Group Marketing Services | $717 | 159% |
| Guardian | $717 | 159% |
| Health America | $717 | 159% |
| Health Smart | $717 | 159% |
| Healthez | $717 | 159% |
| Healthgram | $717 | 159% |
| Healthscope | $717 | 159% |
| Humana | $717 | 159% |
| Insight | $717 | 159% |
| Intercare | $717 | 159% |
| Jfp Benefit Management | $717 | 159% |
| Jp Farley Corporation | $717 | 159% |
| Key Benefit Administrator | $717 | 159% |
| Liberty Union Life Assurance Co | $717 | 159% |
| Lucent Health | $717 | 159% |
| Luminare Health | $717 | 159% |
| Luminare Health (Detroit) | $717 | 159% |
| Medben | $717 | 159% |
| Medcost | $717 | 159% |
| Medical Mutual | $717 | 159% |
| Mutual Health Services | $717 | 159% |
| Mutual Of Omaha | $717 | 159% |
| Ncas | $717 | 159% |
| Nippon Life Ins | $717 | 159% |
| Nova | $717 | 159% |
| Painters Union Insurance Fund | $717 | 159% |
| Physicians Mutual | $717 | 159% |
| Plumbers Local 98 Insurance Fund | $717 | 159% |
| Prairie States | $717 | 159% |
| Primary Physician Care | $717 | 159% |
| Professional Benefit Administrators | $717 | 159% |
| Secureone Preferred United Plans | $717 | 159% |
| The Loomis Company | $717 | 159% |
| Trustmark Small Business Benefits | $717 | 159% |
| Unicare | $717 | 159% |
| Unified Group Services | $717 | 159% |
| Us Health And Life | $717 | 159% |
| Valenz | $717 | 159% |
| Varipro | $717 - $735 | 159% |
| Western & Southern Financial Group | $717 | 159% |
| Wps | $717 | 159% |
| Priority Health | $722 | 160% |
| First Health | $724 | 161% |