CMS Price Transparency Data

Blood transfusion

Facility: Uchealth Grandview Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,012
Cash Discount Price: $935
vs. Medicare Baseline: 2.25x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Uchealth Grandview Hospital is $1,012. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $935. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.25x the Medicare baseline. Located in 5623 Pulpit Peak Vw, Colorado Springs, CO.

Cash / Self-Pay

$935

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,012

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: $935 (207%)

Insurance Median: $1,012 (225%)

Cash: $935 (207% of Medicare)

Ins. Median: $1,012 (225% 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 225% of the Medicare baseline (a markup of 125%). 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
Select Health	$77 - $983	17%
Blue Cross Blue Shield	$195 - $3,568	43%
Aetna	$439 - $3,221	97%
Cigna	$439 - $4,300	97%
Cms	$439	97%
Devoted Health	$439	97%
Humana	$439	97%
Kaiser	$439 - $902	97%
UnitedHealthcare	$439 - $1,550	97%
Simplified Benefits Administration	$852 - $1,012	189%
Denver Health Medical Plan	$1,335	296%
Rocky Mountain Health Plan	$1,442	320%
First Health	$1,575	349%
Multiplan/Phcs	$1,842	409%

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 $935.
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 Uchealth Grandview Hospital 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.