CMS Price Transparency Data

Blood transfusion

Facility: M Health Fairview Southdale Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $847
Cash Discount Price: $502
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at M Health Fairview Southdale Hospital is $847. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $502. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.88x the Medicare baseline. Located in 6401 France Avenue South, Edina, MN.

Cash / Self-Pay

$502

Average discount available for prompt cash payment at this facility.

Insurance Median

$847

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: $502 (111%)

Insurance Median: $847 (188%)

Cash: $502 (111% of Medicare)

Ins. Median: $847 (188% 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	$31 - $984	7%
Itasca Medical Care	$31 - $435	7%
Primewest	$31 - $435	7%
South Country Health Alliance	$31 - $435	7%
Ucare	$31 - $1,000	7%
Medica	$32 - $967	7%
Blue Cross Blue Shield	$35 - $453	8%
Hennepin Health	$35 - $440	8%
Sanford Health Plan	$41 - $859	9%
Security Health Plan	$41 - $1,094	9%
UnitedHealthcare	$41 - $1,383	9%
Wellcare	$41 - $435	9%
America'S Ppo	$577 - $1,050	128%
First Health	$909 - $1,196	202%
Multiplan	$942 - $1,239	209%
Private Healthcare Systems	$942 - $1,239	209%
Wisconsin Physician Services	$997 - $1,312	221%

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 $502.
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 M Health Fairview Southdale 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.