CMS Price Transparency Data

Blood transfusion

Facility: Astera Health

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $1,423
Cash Discount Price: $1,284
vs. Medicare Baseline: 3.16x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Astera Health is $1,423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,284. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 3.16x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$1,284

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,423

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: $1,284 (285%)

Insurance Median: $1,423 (316%)

Cash: $1,284 (285% of Medicare)

Ins. Median: $1,423 (316% 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 316% of the Medicare baseline (a markup of 216%). 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 Plus Pmap [40002]	$33 - $5,128	7%
Blue Cross Blue Shield	$42 - $5,128	9%
Health Partners [10045]	$42 - $5,128	9%
Medica Nonpmap [10056]	$42 - $138,539	9%
Primewest Non Pmap [30004]	$42 - $5,128	9%
Ucare Pmap [30006]	$647 - $1,691	144%
Medica Pmap [10057]	$663 - $3,448	147%
Primewest Pmap [30003]	$663 - $3,448	147%
Ucare Non Pmap [30007]	$747 - $5,385	166%
Health Partners Pmap [10046]	$895 - $2,104	199%
Ucare Commercial [10705]	$1,234 - $3,109	274%
UnitedHealthcare	$1,321 - $3,233	293%
Multiplan	$1,423 - $3,346	316%
Sanford Health Plan [10120]	$1,512 - $3,555	335%
Aetna	$1,601 - $3,764	355%

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 $1,284.
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 Astera Health 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.