CMS Price Transparency Data

Blood transfusion

Facility: Northwestern Medicine Delnor Community Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,568
Cash Discount Price: $10,130
vs. Medicare Baseline: 5.70x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Northwestern Medicine Delnor Community Hospital is $2,568. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,130. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 5.70x the Medicare baseline. Located in 300 Randall Rd, Geneva, IL.

Cash / Self-Pay

$10,130

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,568

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: $10,130 (2247%)

Insurance Median: $2,568 (570%)

Cash: $10,130 (2247% of Medicare)

Ins. Median: $2,568 (570% 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 570% of the Medicare baseline (a markup of 470%). 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
UnitedHealthcare	$329 - $4,076	73%
Blue Cross Blue Shield	$607 - $2,842	135%
Aetna	$664 - $2,768	147%
Cigna	$889 - $3,261	197%
Carelon Behavioral Health [159]	$2,038	452%
Health'S Finest Network [126]	$2,038 - $3,465	452%
First Health Plan [6034]	$2,527 - $2,812	561%
Healthlink [125]	$2,568	570%
The Alliance [1703]	$2,618	581%
Multiplan/Phcs [142]	$3,057 - $4,076	678%
Compsych [112]	$3,261	723%
Beechstreet [176]	$3,668	814%

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 $10,130.
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 Northwestern Medicine Delnor 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.