CMS Price Transparency Data

Blood transfusion

Facility: Harlem Hospital Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $727
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Harlem Hospital Center is $727. 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 506 Lenox Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$727

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: $727 (161%)
Ins. Median: $727 (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 - $1,514 8%
Aetna $38 - $1,626 8%
Emblem $49 - $908 11%
Wellcare $53 12%
Fidelis $71 - $1,514 16%
Blue Cross Blue Shield $517 - $1,747 115%
Elderplan $517 115%
Vaccn $517 115%
Vnsny $517 - $686 115%
Centers Plan For Healthy Living $538 119%
Metroplus $614 - $1,514 136%
Amidacare $673 149%
Carelon $673 - $884 149%
Senior Whole Health $673 149%
United $673 - $1,852 149%
United Behavioral Health $673 - $740 149%
Centerlight $680 151%
Affinity $686 - $1,514 152%
Carelon (Amida Care) $686 152%
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: 506 Lenox Avenue, New York, NY 10037
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals