CMS Price Transparency Data

Blood transfusion

Facility: NYU Langone Hospitals

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,106
Cash Discount Price: $667
vs. Medicare Baseline: 4.67x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at NYU Langone Hospitals is $2,106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $667. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 4.67x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$667

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,106

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: $667 (148%)

Insurance Median: $2,106 (467%)

Cash: $667 (148% of Medicare)

Ins. Median: $2,106 (467% 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 467% of the Medicare baseline (a markup of 367%). 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
Healthfirst	$40 - $1,802	9%
Ghi	$517 - $12,574	115%
Hip	$517 - $4,846	115%
Medicare (plans)	$517	115%
Wellcare	$517	115%
Centerlight	$528	117%
Amida	$801	178%
Fidelis	$801 - $1,802	178%
Healthplus	$801 - $1,802	178%
Medicaid / KanCare	$801	178%
Metroplus	$801 - $1,802	178%
UnitedHealthcare	$801 - $4,923	178%
Somos	$841 - $1,081	187%
Hamaspik	$1,035 - $7,019	230%
Aetna	$2,106 - $3,509	467%
Multiplan	$2,737	607%
1199	$3,128 - $3,681	694%
Blue Cross Blue Shield	$3,280 - $4,100	728%
Oxford	$4,051 - $4,500	899%
Cigna	$6,487	1439%
Magnacare	$13,453 - $25,798	2985%

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 $667.
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 NYU Langone Hospitals 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.