CMS Price Transparency Data

Blood transfusion

Facility: Montefiore St Luke's Cornwall

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $644
Cash Discount Price: $551
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Montefiore St Luke's Cornwall is $644. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $551. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.43x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$551

Average discount available for prompt cash payment at this facility.

Insurance Median

$644

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: $551 (122%)

Insurance Median: $644 (143%)

Cash: $551 (122% of Medicare)

Ins. Median: $644 (143% 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.

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
Affinity	$8 - $578	2%
Emblem	$8 - $3,480	2%
Healthfirst	$8 - $1,303	2%
Medicaid / KanCare	$8	2%
Cdphp	$364 - $551	81%
Mediblue	$534	118%
Aetna	$545 - $2,552	121%
Blue Cross Blue Shield	$551 - $3,713	122%
Fidelis	$551 - $639	122%
Hudson Valley	$551	122%
Oscar	$551 - $7,276	122%
Point Comfort	$551	122%
UnitedHealthcare	$551 - $2,851	122%
Villagecaremax	$551	122%
Vnsny Choice	$551	122%
Centerlight	$567	126%
Wellcare	$567	126%
Hamaspik	$595	132%
Cigna	$599 - $666	133%
Humana	$606	134%
Centivo	$819	182%
Northwell	$845 - $1,481	187%
Geha	$892 - $2,552	198%
Meritain Health	$892 - $2,552	198%
Nippon Life Insurance	$892 - $2,552	198%
Magnacare	$975 - $3,000	216%
American Postal Workers	$2,851	633%
Seiu1199	$5,826	1293%

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 $551.
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 Montefiore St Luke's Cornwall 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.