CMS Price Transparency Data

Blood transfusion

Facility: Englewood Hospital and Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $926
  • Cash Discount Price: $597
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Englewood Hospital and Medical Center is $926. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $597. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.05x the Medicare baseline. Located in 350 Engle St, Englewood, NJ.
Cash / Self-Pay
$597

Average discount available for prompt cash payment at this facility.

Insurance Median
$926

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: $597 (132%)
Insurance Median: $926 (205%)
Cash: $597 (132% of Medicare)
Ins. Median: $926 (205% 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 205% of the Medicare baseline (a markup of 105%). 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
Horizon New Jersey Health - Dsnp $13 - $515 3%
Multiplan $45 - $2,923 10%
Hip Health Plan $463 - $489 103%
Wellcare_755 $467 104%
Heathnet Federal Services $474 105%
Aetna $504 - $2,935 112%
Americhoice_732 $515 114%
Amerigroup_758 $515 114%
Amerihealth_766 $515 114%
Blue Cross Blue Shield $515 - $3,459 114%
Clover_733 $515 114%
Humana $515 114%
UnitedHealthcare $515 - $597 114%
Emblem_734 $527 117%
Americhoice_756 $538 119%
Wellcare_765 $556 123%
Amerigroup_754 $586 130%
Health Care Support_787 $901 200%
Amerihealth_760 $926 205%
Amerihealth_757 $3,102 688%
Horizon $3,490 - $3,723 774%
Magnacare_763 $3,580 794%
Magnacare_769 $3,580 794%
Oxford_741 $3,890 863%
Qualcare_752 $3,944 875%
Qualcare $3,997 887%
Magnacare_768 $4,176 926%
Magnacare_770 $4,176 926%
Bergen $4,474 993%
Coventry $4,474 993%
Magnacare $4,773 1059%
Cigna $5,608 1244%
Qualcare_783 $7,783 1727%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 350 Engle St, Englewood, NJ 07631
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals