CMS Price Transparency Data

Blood transfusion

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,007
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Arthur G James Cancer Hospital and Research Institute is $1,007. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.23x the Medicare baseline. Located in 460 W 10Th Ave, Columbus, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,007

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%)

Insurance Median: $1,007 (223%)

Ins. Median: $1,007 (223% 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 223% of the Medicare baseline (a markup of 123%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthspan	$368 - $5,413	82%
Medigold	$368	82%
Upper Ohio Valley	$368 - $5,413	82%
Medicare (plans)	$371 - $5,467	82%
Humana	$375 - $5,521	83%
Medicaid / KanCare	$425 - $584	94%
Aetna	$446 - $5,388	99%
United	$467 - $1,528	104%
Caresource	$554 - $829	123%
Mmo	$554 - $1,418	123%
Molina	$554 - $5,388	123%
Odrc	$584	130%
Blue Cross Blue Shield	$617 - $1,592	137%
Buckeye Community	$620 - $823	138%
Amerihealth	$625 - $905	139%
Osu Health Plan	$767 - $1,111	170%
Lifetrac	$1,091 - $1,142	242%
Ohio Ppo	$1,102	244%
Ohiohealth	$1,209 - $1,226	268%
Cigna	$1,217 - $1,260	270%
Frontpath	$1,343	298%
Healthsmart	$1,511	335%
Multiplan	$1,561	346%
Ohio Dept Of Health	$4,289	952%

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 $X.
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 Arthur G James Cancer Hospital and Research Institute 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.