CMS Price Transparency Data

Blood transfusion

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $3,189
Cash Discount Price: $8,305
vs. Medicare Baseline: 7.08x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at HCA Healthone Presbyterian St Luke's is $3,189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,305. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 7.08x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$8,305

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,189

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: $8,305 (1843%)

Insurance Median: $3,189 (708%)

Cash: $8,305 (1843% of Medicare)

Ins. Median: $3,189 (708% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 708% of the Medicare baseline (a markup of 608%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Pinnacol Workers Comp	$668	148%
Multiplan	$696 - $7,474	154%
Cigna	$1,205 - $5,315	267%
Vail Health	$1,262	280%
Kaiser	$1,661 - $2,159	369%
United	$1,719 - $3,737	381%
Blue Cross Blue Shield	$2,125 - $6,146	471%
Aetna	$2,491 - $4,833	553%
Bright Health	$2,491	553%
Rocky Mountain Health Plan	$2,720	603%
Emerging Therapy Solutions	$3,986 - $5,315	884%
Kaiser National Transplant	$3,986	884%
Colorado Program For Children With Special Needs	$4,235	940%
Western Plains Community Health	$5,398	1198%
Northcare	$5,813	1290%
Physician Health Partners	$5,813	1290%
Medical Development International	$6,644	1474%
Prime Health	$7,474	1658%

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 $8,305.
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 HCA Healthone Presbyterian St Luke's 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.