CMS Price Transparency Data

Blood transfusion

Facility: Garnet Health Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $964
  • Cash Discount Price: $253
  • vs. Medicare Baseline: 2.14x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Garnet Health Medical Center is $964. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.14x the Medicare baseline. Located in 707 East Main Street, Middletown, NY.
Cash / Self-Pay
$253

Average discount available for prompt cash payment at this facility.

Insurance Median
$964

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: $253 (56%)
Insurance Median: $964 (214%)
Cash: $253 (56% of Medicare)
Ins. Median: $964 (214% 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 214% of the Medicare baseline (a markup of 114%). 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
Magnacare $123 - $197 27%
Aetna $137 - $2,231 30%
Local 1199 $137 - $2,231 30%
Mvp $185 41%
Emblem Health $226 50%
Fidelis $562 125%
Wellcare $563 125%
Rojw $964 214%
Northwell Direct $1,129 250%
Geisinger Health Plan $1,377 306%
Cigna $2,494 553%
UnitedHealthcare $2,739 608%
Blue Cross Blue Shield $2,764 - $3,490 613%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 East Main Street, Middletown, NY 10940
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals