CMS Price Transparency Data

Blood transfusion

Facility: Jfk University Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,694
Cash Discount Price: $461
vs. Medicare Baseline: 3.76x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Jfk University Medical Center is $1,694. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $461. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.76x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$461

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,694

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: $461 (102%)

Insurance Median: $1,694 (376%)

Cash: $461 (102% of Medicare)

Ins. Median: $1,694 (376% 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 376% of the Medicare baseline (a markup of 276%). 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
UnitedHealthcare	$14 - $2,012	3%
Karna	$96	21%
Oxford	$311 - $2,003	69%
Aetna	$390 - $4,025	87%
Clover	$436	97%
Horizon	$437 - $2,249	97%
Wellcare	$437 - $484	97%
Amerigroup	$437 - $484	97%
Vaccn	$437 - $484	97%
United Community/Americhoice	$459 - $509	102%
Blue Cross Blue Shield	$484	107%
Seoul Medical Group	$520	115%
Intergroup	$1,694	376%
Activecare First McO	$1,694	376%
Bergen Risk	$1,815	403%
Prime Health	$1,936	430%
Multiplan - PHCS	$2,057	456%
Brighton Health Plan	$2,178	483%
Qualcare	$2,241	497%
Amerihealth	$2,289	508%
Cigna	$2,329	517%

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 $461.
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 Jfk University 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.