CMS Price Transparency Data

Blood transfusion

Facility: Sterling Regional Medcenter

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,053
Cash Discount Price: $679
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sterling Regional Medcenter is $1,053. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $679. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.34x the Medicare baseline. Located in 615 Fairhurst St, Sterling, CO.

Cash / Self-Pay

$679

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,053

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: $679 (151%)

Insurance Median: $1,053 (234%)

Cash: $679 (151% of Medicare)

Ins. Median: $1,053 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Aetna	$316 - $1,579	70%
Banner Health	$351 - $526	78%
Blue Cross Blue Shield	$351 - $1,378	78%
Healthspring Life & Health Insurance Company, Inc.	$351 - $526	78%
Medica	$351 - $1,414	78%
Medicare (plans)	$351 - $526	78%
Assist Health Group	$421 - $632	93%
Clear Spring Health	$439	97%
UnitedHealthcare	$439 - $1,610	97%
Longevity	$453	101%
Humana	$466	103%
Devoted Health Services	$483	107%
Pinnacol Assurance Workers Comp	$550 - $825	122%
Denver Health Medical Plan	$685 - $1,028	152%
Apostrophe, Inc.	$1,019 - $1,528	226%
First Choice Health Network	$1,019 - $1,528	226%
First Choice Of The Midwest	$1,075 - $1,613	239%
Hue Health, Inc	$1,075 - $1,613	239%
Rocky Mountain Health Plans	$1,075 - $1,613	239%
Multiplan	$1,098 - $1,647	244%

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 $679.
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 Sterling Regional Medcenter 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.