CMS Price Transparency Data

Blood transfusion

Facility: Essentia Health St Mary's Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $625
  • Cash Discount Price: $750
  • vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Essentia Health St Mary's Medical Center is $625. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $750. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.39x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$750

Average discount available for prompt cash payment at this facility.

Insurance Median
$625

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: $750 (166%)
Insurance Median: $625 (139%)
Cash: $750 (166% of Medicare)
Ins. Median: $625 (139% 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.

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
Medica Access $376 83%
Primewest $419 93%
Itasca Med Care $437 97%
Advocare/Security Health $438 97%
Blue Cross Blue Shield $438 - $1,001 97%
Freedom Blue Ppo $438 97%
Healthpartners Care Msho / Mcr Adv $438 97%
Imcare Msho (Ref Req) $438 97%
Imcare Msho Pcc Prime $438 97%
Imcare Msho Ref Req $438 97%
Medica Advantage Solutions $438 97%
Medica Msho/Dual Solutions $438 97%
Medica Prime Solution Group $438 97%
Medicare (plans) $438 97%
Nd Va Administration $438 97%
Platinum Blue / Vantage Blue $438 97%
Primewest Msho $438 97%
Secure Blue Msho $438 97%
Ubh Cost Plan $438 97%
Ubh Msho $438 97%
Ucare Msho $438 97%
UnitedHealthcare $438 - $832 97%
Healthpartners Care Pmap $452 100%
Sanford Health Plan $487 - $774 108%
Blue Plus Pmap Pcc Prime $502 - $568 111%
Medica $628 - $645 139%
Medica Uplan $628 139%
Healthpartners $680 - $812 151%
Medica Choice $694 154%
Ucare $747 166%
Cigna $812 180%
Healthpartners Pcc Prime $812 180%
Wea $818 - $875 181%
Security Health $875 194%
America'S Ppo $880 195%
Wps $943 - $954 209%
Aetna $966 214%
Healthscope Benefits $966 214%
Healtheos $977 217%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals