CMS Price Transparency Data

Blood transfusion

Facility: Elmhurst Hospital Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $724
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Elmhurst Hospital Center is $724. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.61x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$724

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%)
Insurance Median: $724 (161%)
Ins. Median: $724 (161% 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
Healthfirst $34 - $1,481 8%
Aetna $38 - $1,626 8%
Emblem $50 - $889 11%
Wellcare $54 12%
Fidelis $72 - $1,481 16%
Blue Cross Blue Shield $517 - $1,725 115%
Elderplan $517 115%
Vaccn $517 115%
Vnsny $517 - $671 115%
Centers Plan For Healthy Living $538 119%
Metroplus $600 - $1,481 133%
Amidacare $658 146%
Carelon $658 - $884 146%
Senior Whole Health $658 146%
United $658 - $2,144 146%
United Behavioral Health $658 - $724 146%
Affinity $671 - $1,481 149%
Carelon (Amida Care) $671 149%
Centerlight $680 151%
Oscar $776 172%
Cigna $1,020 226%
Magnacare $1,020 226%
Multiplan $1,088 241%
Local 1199 $1,156 256%
Villagecare Max $1,156 256%
Oxford $1,531 - $1,736 340%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals