CMS Price Transparency Data

Blood transfusion

Facility: Hackensack University Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,815
Cash Discount Price: $515
vs. Medicare Baseline: 4.03x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Hackensack University Medical Center is $1,815. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $515. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.03x the Medicare baseline. Located in 30 Prospect Ave, Hackensack, NJ.

Cash / Self-Pay

$515

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,815

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: $515 (114%)

Insurance Median: $1,815 (403%)

Cash: $515 (114% of Medicare)

Ins. Median: $1,815 (403% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 403% of the Medicare baseline (a markup of 303%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Karna	$96	21%
UnitedHealthcare	$412 - $84,414	91%
Clover	$436	97%
Oxford	$489 - $1,778	108%
Aetna	$502 - $7,773	111%
Blue Cross Blue Shield	$515	114%
Horizon	$515 - $2,360	114%
Vaccn	$515	114%
Wellcare	$515	114%
United Community/Americhoice	$541	120%
Seoul Medical Group	$692	154%
Intergroup	$1,694	376%
Bergen Risk	$1,815	403%
Lhp Health	$1,912	424%
Cigna	$1,936 - $2,341	430%
Activecare First McO	$2,057	456%
Chn	$2,057	456%
Multiplan - PHCS	$2,057	456%
Qualcare	$2,134	473%
Brighton Health Plan	$2,178	483%
Amerihealth	$2,420	537%

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 $515.
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 Hackensack University Medical 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.