CMS Price Transparency Data

Blood transfusion

Facility: Marlette Regional Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $768
Cash Discount Price: $571
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Marlette Regional Hospital is $768. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $571. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.70x the Medicare baseline. Located in 2770 Main Street, Marlette, MI.

Cash / Self-Pay

$571

Average discount available for prompt cash payment at this facility.

Insurance Median

$768

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: $571 (127%)

Insurance Median: $768 (170%)

Cash: $571 (127% of Medicare)

Ins. Median: $768 (170% 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
United Healt	$668 - $817	148%
Aetna	$697 - $853	155%
Priority Health	$697 - $853	155%
Blue Cross Blue Shield	$717 - $877	159%
Cofinity	$719 - $880	160%
Hap	$719 - $880	160%
Mclaren Health Plan	$719 - $880	160%

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 $571.
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 Marlette Regional Hospital 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.