CMS Price Transparency Data

Blood transfusion

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $2,344
Cash Discount Price: $11,808
vs. Medicare Baseline: 5.20x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Northwestern Medicine Central Dupage Hospital is $2,344. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,808. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 5.20x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$11,808

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,344

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: $11,808 (2620%)

Insurance Median: $2,344 (520%)

Cash: $11,808 (2620% of Medicare)

Ins. Median: $2,344 (520% 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 520% of the Medicare baseline (a markup of 420%). 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
Blue Cross Blue Shield	$48 - $4,076	11%
Humana	$48 - $4,076	11%
Countycare Il Cook Co [1607]	$281	62%
Medicaid / KanCare	$281	62%
Aetna	$583 - $2,348	129%
Cigna	$872 - $3,261	193%
Carelon Behavioral Health [159]	$2,038	452%
Health'S Finest Network [126]	$2,038 - $3,717	452%
UnitedHealthcare	$2,046 - $4,076	454%
Multiplan/Phcs [142]	$2,340 - $4,076	519%
Dreyer Med Ipa Advocate [1409]	$2,446	543%
Magellan Behavioral Hlth [136]	$2,446	543%
Healthlink [125]	$2,568	570%
The Alliance [1703]	$2,618	581%
Choicecare [177]	$3,122	693%
First Health Plan [6034]	$3,134	695%
Compsych [112]	$3,261	723%

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 $11,808.
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 Central Dupage 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.