CMS Price Transparency Data

Blood transfusion

Facility: Essentia Health St Marys - Detroit Lakes

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 36430
  • Insurance Median: $578
  • Cash Discount Price: $564
  • vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Blood transfusion at Essentia Health St Marys - Detroit Lakes is $578. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $564. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 1027 Washington Ave, Detroit Lakes, MN.
Cash / Self-Pay
$564

Average discount available for prompt cash payment at this facility.

Insurance Median
$578

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: $564 (125%)
Insurance Median: $578 (128%)
Cash: $564 (125% of Medicare)
Ins. Median: $578 (128% 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
Blue Cross Blue Shield $290 - $1,911 64%
Healthpartners Care Pmap $342 76%
Sanford Healthplan $377 - $774 84%
Primewest $419 93%
Itasca Med Care $437 97%
Advocare/Security Health $460 102%
Freedom Blue Ppo $460 102%
Healthpartners Care Msho / Mcr Adv $460 102%
Imcare Msho Pcc Prime $460 102%
Imcare Msho Ref Req $460 102%
Medica Advantage Solutions $460 102%
Medica Msho/Dual Solutions $460 102%
Medica Prime Solution Group $460 102%
Medicare (plans) $460 102%
Nd Va Administration $460 102%
Platinum Blue/Vantage Blue $460 102%
Primewest Msho $460 102%
Secure Blue Msho $460 102%
Ubh Cost Plan $460 102%
Ubh Msho $460 102%
Ucare Msho $460 102%
UnitedHealthcare $460 - $738 102%
Medica Uplan $558 124%
Ucare $578 128%
Healthpartners $590 - $644 131%
Medica $613 - $681 136%
Wea $632 - $676 140%
Cigna $644 143%
Healthpartners Pcc Prime $644 143%
America'S Ppo $680 151%
Medica Choice $702 156%
Wps $729 - $738 162%
Aetna $746 166%
Healtheos $755 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1027 Washington Ave, Detroit Lakes, MN 56501
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals