CMS Price Transparency Data

Blood transfusion

Facility: Strong Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $551
Cash Discount Price: $2,302
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Strong Memorial Hospital is $551. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,302. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.22x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.

Cash / Self-Pay

$2,302

Average discount available for prompt cash payment at this facility.

Insurance Median

$551

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: $2,302 (511%)

Insurance Median: $551 (122%)

Cash: $2,302 (511% of Medicare)

Ins. Median: $551 (122% 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
Blue Cross Blue Shield	$8 - $1,473	2%
Excellus [2201]	$8	2%
Medicaid / KanCare	$8 - $12	2%
Molina Healthcare [1723], Molina Healthcare [5189]	$8	2%
Molina Healthcare [5189]	$8	2%
UnitedHealthcare	$8 - $569	2%
Mvp [2900]	$10 - $1,818	2%
Fidelis [5155]	$18	4%
Martins Point [1205]	$517 - $551	115%
Medicare (plans)	$517 - $717	115%
Aetna	$587 - $621	130%
Humana	$601 - $662	133%
Cigna	$1,091 - $1,972	242%

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 $2,302.
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 Strong Memorial Hospital 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.