CMS Price Transparency Data

Blood transfusion

Facility: Wheatland Memorial Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $775
Cash Discount Price: $887
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Wheatland Memorial Hospital is $775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $887. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.72x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.

Cash / Self-Pay

$887

Average discount available for prompt cash payment at this facility.

Insurance Median

$775

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: $887 (197%)

Insurance Median: $775 (172%)

Cash: $887 (197% of Medicare)

Ins. Median: $775 (172% 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
Healthnet Federal-All Plans	$306 - $1,393	68%
Humana	$306 - $1,393	68%
Medica Prime Solutions-All Plans	$306 - $1,393	68%
Pacific Source Mcr Adv	$306 - $1,393	68%
Triwest-All Plans	$306 - $1,393	68%
Amish Old Orders-All Plans	$376 - $1,713	83%
Allegiance Provider-All Plans	$427 - $1,942	95%
6 Degrees Health-All Plans	$477 - $2,170	106%
Americas Choice-All Plans	$477 - $2,170	106%
Community Health Ntwk-All Plans	$477 - $2,170	106%
Fedmed Network-All Plans	$477 - $2,170	106%
First Choice Big Sky-All Plans	$477 - $2,170	106%
Interwest Ppo-All Plans	$477 - $2,170	106%
Mountain Health Co-Op-All Plans	$477 - $2,170	106%
Pacific Source-All Other Plans	$477 - $2,170	106%
Pacific Steel & Recycling-All Plans	$477 - $2,170	106%
Rocky Mountain Health Network-All Plans	$477 - $2,170	106%
Three Rivers-All Plans	$477 - $2,170	106%
First Health-All Plans	$482 - $2,193	107%
Ccn-All Plans	$487 - $2,216	108%
UnitedHealthcare	$492 - $2,239	109%
City Of Billings-All Plans	$753 - $3,426	167%

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 $887.
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 Wheatland Memorial Hospital 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.