CMS Price Transparency Data

Blood transfusion

Facility: St Christopher's Hospital for Children

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $167
Cash Discount Price: $316
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at St Christopher's Hospital for Children is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $316. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.37x the Medicare baseline. Located in 160 East Erie Ave, Philadelphia, PA.

Cash / Self-Pay

$316

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $316 (70%)

Insurance Median: $167 (37%)

Cash: $316 (70% of Medicare)

Ins. Median: $167 (37% 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
Geisinger	$34 - $284	8%
Pa Health & Wellness	$38	8%
Amerihealth Caritas	$42	9%
Aetna	$49 - $474	11%
Upmc	$50	11%
Keystone First	$53	12%
Gateway	$62	14%
Blue Cross Blue Shield	$111 - $700	25%
Health Partners	$142 - $170	32%
Wellpoint Nj (Formerly Amerigroup)	$167	37%
Cigna	$177	39%
Horizon Nj Health	$253	56%
UnitedHealthcare	$1,164	258%

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 $316.
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 St Christopher's Hospital for Children 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.