CMS Price Transparency Data

Blood transfusion

Facility: Sanford Westbrook Medical Center

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,141
Cash Discount Price: $1,093
vs. Medicare Baseline: 2.53x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Sanford Westbrook Medical Center is $1,141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,093. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 2.53x the Medicare baseline. Located in 920 Bell Avenue Po Box 188, Westbrook, MN.

Cash / Self-Pay

$1,093

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,141

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: $1,093 (242%)

Insurance Median: $1,141 (253%)

Cash: $1,093 (242% of Medicare)

Ins. Median: $1,141 (253% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 253% of the Medicare baseline (a markup of 153%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$331 - $1,264	73%
Ucare	$459 - $1,200	102%
Sanford Health Plan Align	$585	130%
Wellmark Sd	$627	139%
Aetna	$634 - $1,187	141%
Health Partners	$634 - $1,093	141%
Medicare (plans)	$634	141%
UnitedHealthcare	$634 - $1,141	141%
Primewest	$645 - $691	143%
Security Health Plan	$751	167%
Sanford Health Plan	$1,078 - $1,269	239%
Medica	$1,201 - $1,292	266%
Cigna	$1,229	273%
First Choice Health Network	$1,229	273%
Healthez	$1,229	273%
Multiplan	$1,229	273%

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 $1,093.
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 Sanford Westbrook Medical Center 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.