CMS Price Transparency Data

Blood transfusion

Facility: Metrohealth System

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $892
Cash Discount Price: $894
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Metrohealth System is $892. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $894. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.98x the Medicare baseline. Located in 2500 Metrohealth Drive, Cleveland, OH.

Cash / Self-Pay

$894

Average discount available for prompt cash payment at this facility.

Insurance Median

$892

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: $894 (198%)

Insurance Median: $892 (198%)

Cash: $894 (198% of Medicare)

Ins. Median: $892 (198% 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
Medical Mutual	$227 - $1,660	50%
Aarp	$417	93%
Valor Health	$422	94%
Perennial Advantage	$426	95%
Mcgregor Pace	$459	102%
Buckeye Health Plan	$543	120%
Caresource	$584	130%
Aetna	$668 - $2,113	148%
Health E Ohio	$877	195%
Blue Cross Blue Shield	$908 - $1,591	201%
Clarity Health	$1,085	241%
Cigna	$1,601	355%
UnitedHealthcare	$2,089	463%

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 $894.
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 Metrohealth System 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.