CMS Price Transparency Data

Blood transfusion

Facility: Capital Health Medical Center - Hopewell

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $492
Cash Discount Price: $2,343
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Capital Health Medical Center - Hopewell is $492. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,343. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.09x the Medicare baseline. Located in One Capital Way, Pennington, NJ.

Cash / Self-Pay

$2,343

Average discount available for prompt cash payment at this facility.

Insurance Median

$492

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: $2,343 (520%)

Insurance Median: $492 (109%)

Cash: $2,343 (520% of Medicare)

Ins. Median: $492 (109% 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
UnitedHealthcare	$13 - $630	3%
Horizon Nj Health	$18	4%
Medicaid / KanCare	$51 - $537	11%
Wellpoint	$52 - $543	12%
Aetna	$65 - $6,482	14%
Cigna	$104 - $9,424	23%
Blue Cross Blue Shield	$120 - $1,503	27%
Oxford Benefit Plan	$201	45%
Medicare (plans)	$492	109%
Clover	$496	110%
Humana	$506	112%
Fidelis	$764	170%
Multiplan	$1,020 - $10,681	226%

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 $2,343.
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 Capital Health Medical Center - Hopewell 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.