CMS Price Transparency Data

Blood transfusion

Facility: Hunterdon Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,708
Cash Discount Price: $1,296
vs. Medicare Baseline: 6.01x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Hunterdon Medical Center is $2,708. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,296. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 6.01x the Medicare baseline. Located in 2100 Wescott Drive, Flemington, NJ.

Cash / Self-Pay

$1,296

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,708

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: $1,296 (288%)

Insurance Median: $2,708 (601%)

Cash: $1,296 (288% of Medicare)

Ins. Median: $2,708 (601% 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 601% of the Medicare baseline (a markup of 501%). 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
Multiplan	$950 - $4,088	211%
Community Care	$1,010 - $4,344	224%
Aetna	$1,229 - $4,262	273%
Cigna	$1,605 - $2,707	356%
Horizon	$1,707 - $3,219	379%
Oxford	$2,205 - $3,301	489%
Amerihealth	$2,560 - $3,832	568%
Qualcare	$2,560 - $3,832	568%
Phcs	$2,902 - $4,344	644%

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 $1,296.
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 Hunterdon 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.