CMS Price Transparency Data

Blood transfusion

Facility: Saint Michael's Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $691
  • Cash Discount Price: $511
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Saint Michael's Medical Center is $691. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $511. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.53x the Medicare baseline. Located in 111 Central Avenue, Newark, NJ.
Cash / Self-Pay
$511

Average discount available for prompt cash payment at this facility.

Insurance Median
$691

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: $511 (113%)
Insurance Median: $691 (153%)
Cash: $511 (113% of Medicare)
Ins. Median: $691 (153% 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.

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 $22 - $1,047 5%
UnitedHealthcare $22 - $1,943 5%
Tricare $409 91%
Aetna $512 - $1,085 114%
Amerihealth $512 114%
Humana $512 114%
Medicare (plans) $512 114%
New Jersey Out of State $512 114%
Wellpoint Amerigroup $512 114%
Wellcare $527 - $691 117%
Clover Health $532 118%
Curana $537 119%
Employer Direct Healthcare $716 159%
Naphcare $793 176%
Cigna $818 181%
Fairprice Healthcare Holdings - Fphh $819 182%
Coventry $1,023 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 111 Central Avenue, Newark, NJ 07102
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals