CMS Price Transparency Data

Blood transfusion

Facility: Nationwide Children's Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $577
Cash Discount Price: $558
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Nationwide Children's Hospital is $577. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $558. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$558

Average discount available for prompt cash payment at this facility.

Insurance Median

$577

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: $558 (124%)

Insurance Median: $577 (128%)

Cash: $558 (124% of Medicare)

Ins. Median: $577 (128% 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
Tricare	$36 - $428	8%
Caresource	$65 - $697	14%
Humana	$78 - $697	17%
Blue Cross Blue Shield	$87 - $697	19%
UnitedHealthcare	$88 - $697	20%
Aetna	$101 - $589	22%
Ohio Ppo Connect	$114 - $577	25%
Osu	$114 - $577	25%
Mmo	$145 - $583	32%
Cigna	$152 - $583	34%
Front Path Health Coalition	$152 - $583	34%
Ohc	$152 - $577	34%
Ohg	$152 - $558	34%
The Health Plan	$152 - $595	34%
Ahpo	$583	129%
Unicare	$589	131%
Emerald Health	$608	135%
First Health	$608	135%
Phcs	$608	135%
Amerihealth	$697	155%
Bchp	$697	155%
Molina	$697	155%

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 $558.
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 Nationwide Children's 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.