CMS Price Transparency Data

Blood transfusion

Facility: Kaleida Health

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $589
Cash Discount Price: $852
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Kaleida Health is $589. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $852. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.31x the Medicare baseline. Located in 100 High Street, Buffalo, NY.

Cash / Self-Pay

$852

Average discount available for prompt cash payment at this facility.

Insurance Median

$589

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: $852 (189%)

Insurance Median: $589 (131%)

Cash: $852 (189% of Medicare)

Ins. Median: $589 (131% 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
Ghi/Emblem Health	$47 - $743	10%
Ghi/Emblem Health - Wchob	$47 - $59	10%
Aetna	$49 - $2,399	11%
Magnacare	$49 - $1,551	11%
Magnacare - Wchob	$49 - $1,551	11%
Univera	$63 - $767	14%
Univera - Wchob	$63 - $746	14%
Independent Health Association	$320 - $872	71%
Independent Health Association - Wchob	$332 - $893	74%
Blue Cross Blue Shield	$376 - $2,055	83%
Tricare	$523	116%
Wellcare	$573	127%
Fidelis	$595	132%
UnitedHealthcare	$598	133%
Cigna	$644 - $782	143%

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 $852.
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 Kaleida Health 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.