CMS Price Transparency Data

Blood transfusion

Facility: UPMC Hamot

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $425
Cash Discount Price: $638
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at UPMC Hamot is $425. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $638. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.94x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$638

Average discount available for prompt cash payment at this facility.

Insurance Median

$425

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: $638 (142%)

Insurance Median: $425 (94%)

Cash: $638 (142% of Medicare)

Ins. Median: $425 (94% 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
Upmc Health Plan	$31 - $498	7%
UnitedHealthcare	$32 - $515	7%
Aetna	$33 - $744	7%
Geisinger	$39	9%
Highmark Wholecare (Prev Gateway)	$41 - $532	9%
Health Partners Plans (Jefferson Health Plan)	$42	9%
Amerihealth Caritas	$43 - $520	10%
Pa Health & Wellness	$47 - $520	10%
Blue Cross Blue Shield	$70 - $505	16%
Upmc Work Partners	$79	18%
Univera	$159 - $468	35%
Independent Health	$188 - $698	42%
Cigna	$319 - $520	71%
Fidelis	$481	107%
Wellcare	$495	110%
Intergroup	$691 - $850	153%
Multiplan	$744 - $850	165%

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 $638.
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 UPMC Hamot 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.