CMS Price Transparency Data

Blood transfusion

Facility: Sparrow Ionia Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $226
Cash Discount Price: $43
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sparrow Ionia Hospital is $226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.50x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$226

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: $43 (10%)

Insurance Median: $226 (50%)

Cash: $43 (10% of Medicare)

Ins. Median: $226 (50% 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
Medicaid / KanCare	$27 - $496	6%
Medicare (plans)	$38 - $240	8%
Aetna	$44 - $677	10%
Covenant Advantage	$44 - $226	10%
Medigold	$44 - $226	10%
Senior Community Care	$44 - $226	10%
Humana	$46 - $731	10%
Priority	$53 - $554	12%
Blue Cross Blue Shield	$54 - $566	12%
UnitedHealthcare	$66 - $693	15%
Cigna	$68 - $715	15%
Great West Healthcare	$68 - $715	15%
Asr	$69 - $722	15%
Blue Care Network	$69 - $722	15%
Health Alliance Plan	$69 - $722	15%
Cofinity	$70 - $731	16%
Mclaren Commercial	$77 - $805	17%
Priority Health Medihmo	$451	100%

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 $43.
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 Sparrow Ionia 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.