CMS Price Transparency Data

Blood transfusion

Facility: Essentia Health Virginia

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $747
Cash Discount Price: $713
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Essentia Health Virginia is $747. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $713. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.66x the Medicare baseline. Located in 901 9Th Street North, Virginia, MN.

Cash / Self-Pay

$713

Average discount available for prompt cash payment at this facility.

Insurance Median

$747

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: $713 (158%)

Insurance Median: $747 (166%)

Cash: $713 (158% of Medicare)

Ins. Median: $747 (166% 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
Medica Access	$261	58%
Primewest	$419	93%
Advocare/Security Health	$429	95%
Blue Cross Blue Shield	$429 - $1,543	95%
Freedom Blue Ppo	$429	95%
Healthpartners Care Msho / Mcr Adv	$429	95%
Imcare Msho Pcc Prime	$429	95%
Imcare Msho Ref Req	$429	95%
Medica Advantage Solutions	$429	95%
Medica Msho/Dual Solutions	$429	95%
Medica Prime Solution Group	$429	95%
Medicare (plans)	$429	95%
Nd Va Administration	$429	95%
Platinum Blue/Vantage Blue	$429	95%
Primewest Msho	$429	95%
Secure Blue Msho	$429	95%
Ubh Cost Plan	$429	95%
Ubh Msho	$429	95%
Ucare Msho	$429	95%
UnitedHealthcare	$429 - $1,000	95%
Itasca Med Care	$437	97%
Healthpartners Care Pmap	$452	100%
Sanford Healthplan	$487 - $774	108%
Blue Plus Pmap Pcc Prime	$533 - $763	118%
Medica	$724 - $804	161%
Medica Uplan	$724	161%
Ucare	$747	166%
Healthpartners	$811 - $1,027	180%
Wea	$818 - $875	181%
Medica Choice	$828	184%
Security Health	$875	194%
America'S Ppo	$880	195%
Wps	$943 - $954	209%
Aetna	$966	214%
Cigna	$1,024 - $1,027	227%
Healthpartners Pcc Prime	$1,024 - $1,027	227%

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 $713.
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 Essentia Health Virginia 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.