CMS Price Transparency Data

Blood transfusion

Facility: Perham Health

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $615
Cash Discount Price: $1,105
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Perham Health is $615. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,105. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.36x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$1,105

Average discount available for prompt cash payment at this facility.

Insurance Median

$615

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: $1,105 (245%)

Insurance Median: $615 (136%)

Cash: $1,105 (245% of Medicare)

Ins. Median: $615 (136% 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
Blue Cross Blue Shield	$470 - $1,156	104%
Health Partners Mcr Adv	$576 - $581	128%
Humana	$576 - $581	128%
Medica Mcr Adv	$576 - $581	128%
Medicare (plans)	$576 - $646	128%
Ucare Mn Senior Health Options	$576 - $581	128%
UnitedHealthcare	$593 - $1,332	132%
Ucare Mn Special Needs Basic Care Dual	$604 - $610	134%
Ucare Mn Medical Assistance	$609 - $615	135%
Ucare Mn Minnesota Care	$609 - $615	135%
Ucare Mn Senior Care Plus	$609 - $615	135%
Ucare Mn Special Needs Basic Care	$609 - $615	135%
Medicaid / KanCare	$610 - $616	135%
Medica Mcaid Mn Care	$620 - $625	138%
Medica Mn (Msho)	$698 - $704	155%
Ucare Individual And Family Plan-All Other Plans	$701 - $707	156%
Medica Mn Senior Hp/Outside Mn	$770 - $777	171%
Health Partners Minnesota Care	$846 - $854	188%
Medica Commercial-All Other Plans	$1,239 - $1,250	275%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$1,270 - $1,281	282%
Health Partners-All Plans	$1,388 - $1,401	308%
Preferred One (Ppo)	$1,439 - $1,452	319%
Sanford Health Plan-All Plans	$1,439 - $1,452	319%

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 $1,105.
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 Perham 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.