CMS Price Transparency Data

Blood transfusion

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $513
Cash Discount Price: $1,274
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Nationwide Children's Hospital Toledo, LLC is $513. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,274. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.14x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$1,274

Average discount available for prompt cash payment at this facility.

Insurance Median

$513

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: $1,274 (283%)

Insurance Median: $513 (114%)

Cash: $1,274 (283% of Medicare)

Ins. Median: $513 (114% 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%
Blue Cross Blue Shield	$40 - $1,083	9%
Caresource	$43 - $473	10%
Paramount	$43	10%
Front Path Health Coalition	$56 - $955	12%
Aetna	$57 - $817	13%
Mcclaren Health Plan	$61 - $955	14%
UnitedHealthcare	$79 - $1,072	18%
Cigna	$101	22%
Ohc	$148 - $1,062	33%
Ohio Ppo Connect	$148 - $1,062	33%
Mmo	$198 - $743	44%
Molina	$451 - $525	100%
Mcclaren Health Plan - Michigan	$464	103%
Amerihealth	$518	115%
Bchp	$518	115%
Humana	$518	115%
First Health	$1,635	363%

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 $1,274.
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 Toledo, LLC 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.