CMS Price Transparency Data
Blood transfusion
Facility: St Charles Hospital
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $517
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at St Charles Hospital is $517. 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 1.15x the Medicare baseline. Located in 200 Belle Terre Road, Port Jefferson, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$517
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: $517 (115%)
Ins. Median: $517 (115% 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 |
|---|---|---|
| Affinity Health Plan | $8 - $18 | 2% |
| Beacon Health Options | $8 - $724 | 2% |
| Beacon Health Strategies | $8 - $724 | 2% |
| Centerlight Healthcare | $8 - $517 | 2% |
| Elderplan Inc. | $8 - $517 | 2% |
| Emblem Health | $8 - $5,148 | 2% |
| Fidelis Care New York | $8 - $517 | 2% |
| Health First | $8 - $1,164 | 2% |
| Health Plus | $8 - $517 | 2% |
| Independent Health | $8 - $517 | 2% |
| Medicaid / KanCare | $8 | 2% |
| Mvp Health Plans | $8 - $3,353 | 2% |
| Senior Whole Health | $8 - $517 | 2% |
| UnitedHealthcare | $8 - $3,488 | 2% |
| Zadroga | $79 | 18% |
| Blue Cross Blue Shield | $507 - $3,488 | 112% |
| Aetna | $517 - $4,663 | 115% |
| Centers Plan For Healthy Living | $517 | 115% |
| Healthspring | $517 | 115% |
| Liberty Health | $517 | 115% |
| Longevity Health Plan | $517 | 115% |
| Medicare (plans) | $517 - $543 | 115% |
| Orthonet - Uniformed Services Family Health Plan | $517 | 115% |
| Pmc | $517 | 115% |
| Tricare | $517 | 115% |
| Universal Healthcare | $517 | 115% |
| Us Family Health Plan | $517 | 115% |
| Veterans Affairs | $517 | 115% |
| Humana | $528 | 117% |
| Agewell New York | $535 | 119% |
| Partners Health Plan | $543 | 120% |
| Wellcare Health Plan Inc | $569 | 126% |
| Brighton | $676 - $5,269 | 150% |
| Oscar Health | $1,379 | 306% |
| Centivo | $1,682 - $3,353 | 373% |
| Allied Wellfare Fund | $2,186 | 485% |
| American Group Administrators | $2,186 | 485% |
| Bakery & Confectionery Union | $2,186 | 485% |
| Cigna | $2,186 - $3,353 | 485% |
| Comprehensive Benefits Consultant | $2,186 | 485% |
| Guardian Life Insurance Company Of America | $2,186 | 485% |
| Maloney And Assoc | $2,186 | 485% |
| Multiplan | $2,186 | 485% |
| Performax | $2,186 | 485% |
| Phcs | $2,186 | 485% |
| Pomco | $2,186 | 485% |
| Tpa Inc | $2,186 | 485% |
| Unicare | $2,186 | 485% |
| United Employees Health Plan | $2,186 | 485% |
| Coventry | $2,489 - $2,859 | 552% |
| Magellan | $2,690 | 597% |
| Galaxy | $3,027 | 672% |
| Three Rivers Provider Network | $3,027 | 672% |
| Surest | $3,204 | 711% |
| Apwu | $3,353 | 744% |
| Daniel H Cook | $3,353 | 744% |
| Nalc | $3,353 | 744% |
| Samba | $3,353 | 744% |
| Aither Health | $3,363 | 746% |
| Alpha Care | $3,363 | 746% |
| Dentaquest | $3,363 | 746% |
| Self Pay | $3,488 | 774% |
| Local 1199 | $3,945 | 875% |
| Mail Handlers Benefit Plan | $4,663 | 1035% |
| Meritain Health | $4,663 | 1035% |
| Nippon Life Insurance Company Of America | $4,663 | 1035% |
| Salvation Army | $4,663 | 1035% |
| American Plan Administrators | $5,148 | 1142% |
| Amerihealth Administrators | $5,148 | 1142% |
| Benefit Services | $5,148 | 1142% |
| Ghi Cbp Ny City Employee Alternate | $5,148 | 1142% |
| International Benefit Administrator | $5,148 | 1142% |
| Ultra Benefits Inc. | $5,148 | 1142% |