CMS Price Transparency Data

Blood transfusion

Facility: North Memorial Health Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $480
Cash Discount Price: $635
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at North Memorial Health Hospital is $480. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $635. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.06x the Medicare baseline. Located in 3300 Oakdale North, Robbinsdale, MN.

Cash / Self-Pay

$635

Average discount available for prompt cash payment at this facility.

Insurance Median

$480

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: $635 (141%)

Insurance Median: $480 (106%)

Cash: $635 (141% of Medicare)

Ins. Median: $480 (106% 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.

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
Health Partners [1061]	$318 - $1,086	71%
Blue Cross Blue Shield	$338 - $838	75%
Medicaid / KanCare	$381	85%
Medica [1086]	$396 - $908	88%
Humana	$442	98%
Medicare (plans)	$442	98%
Ucare [1148]	$442 - $809	98%
UnitedHealthcare	$460 - $1,079	102%
Aetna	$480 - $903	106%
America'S Ppo [1010]	$815 - $867	181%
Phcs [1172]	$903	200%
Multiplan [1176]	$963	214%
Cigna	$1,067	237%

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 $635.
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 North Memorial Health 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.