CMS Price Transparency Data

Blood transfusion

Facility: Boundary Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,052
Cash Discount Price: $1,103
vs. Medicare Baseline: 2.33x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Boundary Community Hospital is $1,052. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,103. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.33x the Medicare baseline. Located in 6640 Kaniksu Street, Bonners Ferry, ID.

Cash / Self-Pay

$1,103

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,052

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: $1,103 (245%)

Insurance Median: $1,052 (233%)

Cash: $1,103 (245% of Medicare)

Ins. Median: $1,052 (233% 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 233% of the Medicare baseline (a markup of 133%). 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
Molina Mcr Adv	$74 - $1,212	16%
UnitedHealthcare	$74 - $1,873	16%
Molina Mcaid	$81 - $1,322	18%
Aetna	$88 - $1,433	20%
Bc Idaho Qhp	$127 - $2,072	28%
Cigna	$128 - $2,094	28%
Regence Blue Shield - All Plans	$130 - $2,116	29%
Pacificsource Comm - All Other Plans	$131 - $2,138	29%
Bc Idaho Comm - All Other Plans	$132 - $2,160	29%
Molina Comm/Mrketplce - All Other Plans	$451	100%

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 $1,103.
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 Boundary Community 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.