CMS Price Transparency Data

Blood transfusion

Facility: Atlantic Rehabilitation Institute, LLC

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $717
  • Cash Discount Price: $717
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Atlantic Rehabilitation Institute, LLC is $717. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $717. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.59x the Medicare baseline. Located in 200 Madison Ave, Madison, NJ.
Cash / Self-Pay
$717

Average discount available for prompt cash payment at this facility.

Insurance Median
$717

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: $717 (159%)
Insurance Median: $717 (159%)
Cash: $717 (159% of Medicare)
Ins. Median: $717 (159% 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
Aetna $717 159%
All Savers Cpd $717 159%
Ama Insurance Msg $717 159%
Ambetter / Centene $717 159%
Amerigroup Mgg (Wellpoint As Of 5/1/24) $717 159%
Amerihealth Cpd $717 159%
Amerihealth Mgg $717 159%
Blue Cross Blue Shield $717 159%
Braven Health Cpd $717 159%
Braven Health Mgd $717 159%
Cigna $717 159%
Claim Doc Llc Cpd $717 159%
First Managed Care Wc Cpd $717 159%
Gateway Mgg $717 159%
Medicaid / KanCare $717 159%
Oscar Health Cpd $717 159%
Oxford Health Plan Cpd $717 159%
Oxford Mgg $717 159%
Qualcare Cpd $717 159%
Qualcare Lynx Wc Cpd $717 159%
UnitedHealthcare $717 159%
Upmc For Life Mgg $717 159%
Wellcare Mgg $717 159%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Madison Ave, Madison, NJ 07940
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL