CMS Price Transparency Data

Blood transfusion

Facility: Boulder Community Health

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $1,032
  • Cash Discount Price: $2,390
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Boulder Community Health is $1,032. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,390. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.29x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$2,390

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,032

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: $2,390 (530%)
Insurance Median: $1,032 (229%)
Cash: $2,390 (530% of Medicare)
Ins. Median: $1,032 (229% 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 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $34 8%
Rocky Mountain Health Maintenance Organization $34 - $453 8%
Colorado Access $37 - $44 8%
Aetna $44 - $4,163 10%
Blue Cross Blue Shield $44 - $2,846 10%
Devoted Health $44 - $1,912 10%
Health Spring $44 - $439 10%
Humana $44 - $439 10%
Medicare (plans) $44 - $1,816 10%
UnitedHealthcare $44 - $2,130 10%
Clear Spring $45 - $453 10%
Select Health Colorado Public Option $61 - $1,816 14%
Select Health Value Network $61 - $1,816 14%
Multiplan $65 - $3,346 14%
Phcs $65 - $3,346 14%
Beech Street Community Medical Associates $67 15%
Kaiser Ppo $67 - $1,034 15%
Kaiser Public Option $67 - $843 15%
Cigna $71 - $3,824 16%
Kaiser $1,029 228%
Rocky Mountain Health Maintenance Organization Private Plan $3,346 742%
Integrated Health Plans Bch $3,585 795%
Casualty Management Network, Prime Health Services Behavioral Health $4,063 901%
Mines And Associates $4,063 901%
Three Rivers Provider Network $4,063 901%
Zelis (Profee) $4,063 901%
Casualty Management Network, Prime Health Services Community Medical Associates $4,302 954%
National Preferred Provider Network $4,302 954%
Rockport Healthcare Group Community Medical Associates $4,302 954%
Usa $4,302 954%
Rockport Healthcare Group Bch $4,445 986%
Health Payors Organization $4,541 1007%
Health Management Network Bch Community Medical Associates $4,589 1018%
Health Management Network Community Medical Associates $4,589 1018%
National Provider Network $4,637 1029%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals