CMS Price Transparency Data
Blood transfusion
Facility: Mount Carmel East & West
Billing Code: 36430 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 36430
- Insurance Median: $916
- Cash Discount Price: $1,768
- vs. Medicare Baseline: 2.03x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Mount Carmel East & West is $916. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,768. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.03x the Medicare baseline. Located in 6001 East Broad Street, Columbus, OH.
Cash / Self-Pay
$1,768
Average discount available for prompt cash payment at this facility.
Insurance Median
$916
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: $1,768 (392%)
Insurance Median: $916 (203%)
Cash: $1,768 (392% of Medicare)
Ins. Median: $916 (203% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $367 - $438 | 81% |
| Aetna | $409 - $2,220 | 91% |
| Blue Cross Blue Shield | $409 - $1,962 | 91% |
| Hospice Mount Carmel | $417 | 93% |
| UnitedHealthcare | $417 - $1,059 | 93% |
| The Health Plan | $426 - $1,289 | 95% |
| Crime Victim Assistance | $632 | 140% |
| Ohio Safe Program | $632 | 140% |
| Oscar | $689 | 153% |
| Enterprise Group Planning | $806 | 179% |
| Custom Design Benefits | $872 | 193% |
| Geha | $881 - $993 | 195% |
| Gravie Admin Services | $881 | 195% |
| Healthez | $881 | 195% |
| Meritain | $881 | 195% |
| Webtpa | $881 | 195% |
| Access Health | $916 | 203% |
| Acclaim | $916 | 203% |
| Administrative Concepts | $916 | 203% |
| Allegeant | $916 | 203% |
| Allied Benefit Systems | $916 | 203% |
| American Family | $916 | 203% |
| American Healthcare Alliance | $916 | 203% |
| American National | $916 | 203% |
| American Republic | $916 | 203% |
| Amerihealth | $916 | 203% |
| Aultcare | $916 | 203% |
| Automated Benefit Services | $916 | 203% |
| Auxiant | $916 | 203% |
| Benefit Administrative Systems,Llc | $916 | 203% |
| Boon Chapman | $916 | 203% |
| Cam Administrative Services | $916 | 203% |
| Christian Brother Services | $916 | 203% |
| Christian Brothers Holy Cross | $916 | 203% |
| Claimchoice Adminstrators | $916 | 203% |
| Comprehensive Benefits | $916 | 203% |
| Continental Life Insurance | $916 | 203% |
| Coventry | $916 | 203% |
| Custom Benefit Administrators | $916 | 203% |
| Cypress Benefit Administrators | $916 | 203% |
| Employee Benefit Concepts | $916 | 203% |
| Employee Benefit Management | $916 | 203% |
| Forest County Potawatomi | $916 | 203% |
| Freedom Life Insurance Company | $916 | 203% |
| Group Administrators | $916 | 203% |
| Group Marketing Services | $916 | 203% |
| Group Pension Administrators | $916 | 203% |
| Guardian | $916 | 203% |
| Health America | $916 | 203% |
| Health Choices | $916 | 203% |
| Healthcare Management Admin | $916 | 203% |
| Insight | $916 | 203% |
| Intercare | $916 | 203% |
| Jfp Benefit Management | $916 | 203% |
| Jp Farley Corporation | $916 | 203% |
| Key Benefit Administrator | $916 | 203% |
| Liberty Union Life Assurance Co | $916 | 203% |
| Lucent Health | $916 | 203% |
| Luminare Health | $916 | 203% |
| Magnacare | $916 | 203% |
| Medcost | $916 | 203% |
| Mutual Health Services | $916 | 203% |
| Mutual Of Omaha | $916 | 203% |
| Ncas | $916 | 203% |
| Nippon Life Ins | $916 | 203% |
| Nova | $916 | 203% |
| Painters Union Insurance Fund | $916 | 203% |
| Physicians Mutual | $916 | 203% |
| Plumbers Local 98 Insurance Fund | $916 | 203% |
| Prairie States | $916 | 203% |
| Preferred One | $916 | 203% |
| Primary Physician Care | $916 | 203% |
| Professional Benefit Administrators | $916 | 203% |
| Secureone Preferred United Plans | $916 | 203% |
| Siho Insurance Services | $916 | 203% |
| Sisco Benefits | $916 | 203% |
| The Loomis Company | $916 | 203% |
| Trustmark Small Business Benefits | $916 | 203% |
| U Of M Health Plan | $916 | 203% |
| Unicare | $916 | 203% |
| Unified Group Services | $916 | 203% |
| Us Health And Life | $916 | 203% |
| Valenz | $916 | 203% |
| Varipro | $916 | 203% |
| Wps | $916 | 203% |
| Quality Care Partners | $943 | 209% |
| Humana | $1,003 - $1,962 | 223% |
| First Health | $1,034 | 229% |
| Medical Mutual | $1,045 - $1,493 | 232% |
| American Postal Workers Secondary | $1,100 | 244% |
| Cigna | $1,100 | 244% |
| Health Partners | $1,100 | 244% |
| Healthgram | $1,100 | 244% |
| Mvp | $1,100 | 244% |
| Priority Health | $1,100 | 244% |
| Rural Carrier Health Benefit Plan | $1,118 | 248% |
| Medben | $1,177 - $1,472 | 261% |
| Consociate | $1,199 | 266% |
| Health Ohio Network | $1,199 | 266% |
| Caresource | $1,432 | 318% |
| Western & Southern Financial Group | $1,452 | 322% |
| Healthlink Inc | $1,472 | 327% |
| Medical Benefits Mutual | $1,472 | 327% |
| Ohio Health Choice | $1,472 | 327% |
| Ohio Ppo Connect | $1,472 | 327% |
| Medi Share | $1,568 | 348% |
| Multiplan | $1,568 | 348% |
| Phcs | $1,568 | 348% |
| Philadelphia American Life Insurance | $1,568 | 348% |
| Ameriben | $1,570 | 348% |
| Luminare Health (Detroit) | $1,570 | 348% |
| Ohiohealthy | $1,570 | 348% |
| Osu Not Independent Choice | $1,570 | 348% |
| Twin Valley Psychiatric | $1,570 | 348% |
| Blue Benefit Administrators Of Massachusetts | $1,587 | 352% |
| Blue Care Network | $1,587 | 352% |
| Blue Distinction Transplant | $1,587 | 352% |
| Blue Shield - Ca | $1,587 | 352% |
| Blue Shield - Id (Regence) | $1,587 | 352% |
| Blue Shield - Ny Highmark Northeastern | $1,587 | 352% |
| Blue Shield - Ny Highmark Western | $1,587 | 352% |
| Blue Shield - Pa (Highmark) | $1,587 | 352% |
| Blue Shield - Wa (Regence) | $1,587 | 352% |
| Health Smart | $1,668 | 370% |
| Bccp | $1,962 | 435% |
| Medicaid / KanCare | $1,962 | 435% |
| Optima Health | $1,962 | 435% |