CMS Price Transparency Data

Blood transfusion

Facility: Suny/Stony Brook University Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $548
Cash Discount Price: $2,287
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Suny/Stony Brook University Hospital is $548. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,287. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.22x the Medicare baseline. Located in Health Sciences Center SUNY, Stony Brook, NY.

Cash / Self-Pay

$2,287

Average discount available for prompt cash payment at this facility.

Insurance Median

$548

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: $2,287 (507%)

Insurance Median: $548 (122%)

Cash: $2,287 (507% of Medicare)

Ins. Median: $548 (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
Healthfirst	$165	37%
Aetna	$219 - $5,417	49%
Blue Cross Blue Shield	$219 - $5,018	49%
Elderplan	$219 - $548	49%
Fidelis Care	$219 - $548	49%
Healthfirst Health Plan	$219 - $548	49%
UnitedHealthcare	$219 - $4,255	49%
Emblemhealth Hip Of Ny	$224 - $6,608	50%
Agewell New York	$241 - $603	53%
Healthfirst Essential Plan 1/2	$250	55%
Healthfirst Essential Plan 3/4	$250	55%
Centerlight	$285 - $712	63%
Partners Health Plan	$285 - $712	63%
Emblemhealth Hip Of Ny Select Care	$1,584 - $4,958	351%
Emblemhealth Ghi	$1,838	408%
Oxford Freedom And Liberty	$2,762	613%
Cigna	$5,171	1147%
Brighton All Payer	$6,468	1435%

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 $2,287.
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 Suny/Stony Brook University 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.