CMS Price Transparency Data

Blood transfusion

Facility: High Point Regional Health System

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $402
Cash Discount Price: $482
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at High Point Regional Health System is $402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $482. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 0.89x the Medicare baseline. Located in 601 N Elm St, High Point, NC.

Cash / Self-Pay

$482

Average discount available for prompt cash payment at this facility.

Insurance Median

$402

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: $482 (107%)

Insurance Median: $402 (89%)

Cash: $482 (107% of Medicare)

Ins. Median: $402 (89% 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
Amerihealth	$140 - $313	31%
Carolina Complete	$140	31%
Healthy Blue	$140	31%
Partners	$140	31%
UnitedHealthcare	$141 - $643	31%
Vaya	$141	31%
Wellcare	$141	31%
Alliance	$142	32%
Trillium	$144	32%
Medcost	$258 - $617	57%
Aetna	$287 - $626	64%
Oscar	$289 - $385	64%
Ambetter / Centene	$308	68%
Blue Cross Blue Shield	$312 - $474	69%
Cigna	$529	117%
Directnet	$569	126%
Private Healthcare Systems	$790	175%
Multiplan	$867	192%
Humana	$896 - $915	199%

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 $482.
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 High Point Regional Health System 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.