CMS Price Transparency Data

Blood transfusion

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $1,133
  • Cash Discount Price: $1,626
  • vs. Medicare Baseline: 2.51x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at University Medical Center of Princeton at Plainsboro is $1,133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,626. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.51x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$1,626

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,133

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: $1,626 (361%)
Insurance Median: $1,133 (251%)
Cash: $1,626 (361% of Medicare)
Ins. Median: $1,133 (251% 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 251% of the Medicare baseline (a markup of 151%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $13 - $1,354 3%
Charity Care $13 3%
Medicaid / KanCare $13 - $1,626 3%
Wellcare $14 3%
Horizon Nj Health $29 6%
Blue Cross Blue Shield $327 - $1,223 73%
Preferred Health Care Eliance $423 94%
Tricare $496 110%
Medicare (plans) $503 - $553 112%
UnitedHealthcare $503 - $1,220 112%
Va Medical Center $503 112%
Cigna $518 - $1,626 115%
Clover Health Plan $533 118%
Humana $543 120%
Us Family Health Plan $571 127%
Horizon Behavioral Health $610 135%
Elap $714 - $906 158%
Beacon Health Options $813 180%
Centivo $906 201%
Claim Watcher $906 201%
Amerihealth $962 213%
Qualcare $990 - $1,382 220%
Princeton Theological Seminary $1,057 235%
Coventry $1,138 252%
Health Net $1,138 252%
Magnacare $1,138 - $3,492 252%
Private Healthcare Systems $1,268 281%
Beech Street $1,301 - $1,382 289%
Intergrated Health Plan $1,301 289%
Intergroup $1,301 289%
Penn Global Medicine Embassy Only $1,301 289%
Allied Trades $1,382 307%
Consumer Health Network $1,382 307%
Devon Health Services $1,382 307%
First Managed Care Option $1,382 307%
Ie Shaffer $1,382 307%
Total Care Network $1,382 307%
Tri-State $1,382 307%
Commercial Other $1,626 361%
Compsych $1,626 361%
Concern Plus $1,626 361%
International Pfs $1,626 361%
Life St. Francis $1,626 361%
Magellan $1,626 361%
Managed Health Network $1,626 361%
Nj Carpenters $1,626 361%
Penn Behavioral Health Corporate Services $1,626 361%
Personnel Health Program $1,626 361%
United Behavioral Health $1,626 361%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals