CMS Price Transparency Data

Blood transfusion

Facility: St Mary Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $504
  • Cash Discount Price: $934
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at St Mary Medical Center is $504. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $934. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.12x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$934

Average discount available for prompt cash payment at this facility.

Insurance Median
$504

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: $934 (207%)
Insurance Median: $504 (112%)
Cash: $934 (207% of Medicare)
Ins. Median: $504 (112% 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.

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
Medicaid / KanCare $32 - $1,164 7%
Keystone First $67 15%
Keystone First Chip $67 15%
Pace-Trinity Health $75 17%
UnitedHealthcare $280 - $1,958 62%
Geha $294 65%
Cigna $368 - $480 82%
Upmc Health Plan $390 87%
Webtpa $390 87%
Amerihealth $464 103%
Blue Cross Blue Shield $464 - $476 103%
Blue Shield - Ca $464 103%
Blue Shield - Id (Regence) $464 103%
Blue Shield - Ny Highmark Western $464 103%
Blue Shield - Wa (Regence) $464 103%
Align Senior Care $485 108%
Medicare (plans) $488 - $856 108%
Aetna $503 - $1,125 112%
Meritain $515 114%
Multiplan $521 116%
Prime Health Services $521 116%
Galaxy Health Network $550 122%
Three Rivers Provider Network $550 122%
Health America Advantra $571 127%
Ambetter / Centene $849 188%
Oscar $856 190%
Prime Healthcare $856 190%
Jefferson Health Plan Commercial $866 192%
Homestead Health Plans Woods Center $927 206%
Group Pension Administrators $1,070 237%
Reedman Toll $1,070 237%
Blue Shield - Pa (Highmark) $1,286 285%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals