CMS Price Transparency Data

Blood transfusion

Facility: University Hospitals Avon Rehabilitation Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $860
Cash Discount Price: $860
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at University Hospitals Avon Rehabilitation Hospital is $860. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $860. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.91x the Medicare baseline. Located in 37900 Chester Rd, Avon, OH.

Cash / Self-Pay

$860

Average discount available for prompt cash payment at this facility.

Insurance Median

$860

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: $860 (191%)

Insurance Median: $860 (191%)

Cash: $860 (191% of Medicare)

Ins. Median: $860 (191% 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
Uh Employees (Administered By Meritian)	$334	74%
Blue Cross Blue Shield	$494 - $860	110%
Healthsmart (Formerly Emerald)	$559	124%
Ohio Health Choice - Preferred Choice Plus	$559	124%
Clarity Health (Enterprise Group Planning Will Be Listed On Id Card As Well)	$636	141%
Occunet Fka Health Ohio Network	$636	141%
Paramount	$645 - $860	143%
Ohio Preferred Network	$688	153%
First Health	$731	162%
Beechstreet	$774	172%
Fortified	$774	172%
Multiplan	$774	172%
Ohio Health Choice	$774	172%
Phcs	$774	172%
Aetna	$860	191%
Ambetter / Centene	$860	191%
Amerihealth Cartias	$860	191%
Antidote Healthe Care Of Ohio	$860	191%
Aultcare	$860	191%
Buckeye	$860	191%
Caresource	$860	191%
Caresource (Marketplace)	$860	191%
Cigna	$860	191%
Devoted	$860	191%
Health Plan	$860	191%
Humana	$860	191%
Jp Farley (Select Employers)	$860	191%
Medical Mutual	$860	191%
Medical Mutual (Supermed, Trad, Medflex)	$860	191%
Medical Mutual (Marketplace Plan)	$860	191%
Molina	$860	191%
Summacare	$860	191%
United	$860	191%
UnitedHealthcare	$860	191%
Wellcare	$860	191%

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 $860.
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 University Hospitals Avon Rehabilitation 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.