CMS Price Transparency Data

Blood transfusion

Facility: Uchealth Pikes Peak Regional Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,242
Cash Discount Price: $1,656
vs. Medicare Baseline: 2.76x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Uchealth Pikes Peak Regional Hospital is $1,242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,656. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.76x the Medicare baseline. Located in 16420 W Us Highway 24, Woodland Park, CO.

Cash / Self-Pay

$1,656

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,242

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: $1,656 (367%)

Insurance Median: $1,242 (276%)

Cash: $1,656 (367% of Medicare)

Ins. Median: $1,242 (276% 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 276% of the Medicare baseline (a markup of 176%). 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	$175 - $1,793	39%
Blue Cross Blue Shield	$274 - $2,575	61%
Aetna	$518 - $1,697	115%
Cigna	$518 - $1,656	115%
Cms	$518	115%
Devoted Health	$518	115%
Humana	$518	115%
Kaiser	$518 - $1,760	115%
UnitedHealthcare	$518 - $1,644	115%
Simplified Benefits Administration	$948 - $1,045	210%
Kaiser Public Option	$1,242	276%
Kaiser Kp Select	$1,490	331%
Multiplan/Phcs	$1,635	363%
First Health	$1,760	390%
Rocky Mountain Health Plan	$1,760	390%

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 $1,656.
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 Pikes Peak Regional 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.